Reactive epidermal hyperplasia to ?-sitosterol and berberine moist exposed burn ointment (MEBO): A case report

ABSTRACT

Moist exposed burn therapy is a therapeutic principle based on the moist environment of the wound, using an ointment of herbal origin that enhances epithelial repair. This is the case of a 42-year-old female who sustained partial thickness burn wounds on her face and upper extremities. Patient was started on wound dressing with 13-sitosterol and berberine moist exposed burn ointment (MEBO) and noted the formation of erythematous verrucous plaques overlying the burned areas after four weeks. Histopathological examination of the lesions revealed papillomatosis, acanthosis, and hyperkeratosis. The lesions resolved upon discontinuation of MEBO and application of a combination of topical steroid, keratolytic, and emollient. The reactive epidermal hyperplasia seen in the case presented may have been due to increased levels of basic fibroblast growth factor in burn wounds treated with MEBO. Careful instructions and close monitoring of patients applying the ointment must be reinforced due to the possibility of reactive inflammatory skin reactions.