HF acid burns are a unique clinical entity. Dilute solutions deeply penetrate before dissociating, thus causing delayed injury and symptoms. Burns to the fingers and nail beds may leave the overlying nails intact. The vast majority of cases involve only small areas of exposure, usually on the digits. The 2 mechanisms that cause tissue damage are corrosive burn from the free hydrogen ions and chemical burn from tissue penetration of the fluoride ions.
Fluoride ions penetrate and form insoluble salts with calcium and magnesium.
Soluble salts also are formed with other cations but dissociate rapidly. Consequently, fluoride ions release, and further tissue destruction occurs. Actual incidence rate is unknown. Burns may involve underlying bone. Systemic fluoride ion poisoning from severe burns is associated with hypocalcemia, hyperkalemia, hypomagnesemia, and sudden death.