Sir, a 20-month-old boy was brought to the emergency department after sustaining an injury to his upper lip by an unusual mechanism. The child had placed a battery-powered dry skin remover, intended for foot care, against his face while his mother's back was turned. The device's blade caught the child's upper lip, and the lip became tangled. The child's mother turned off the device and disconnected its battery, but she was unsuccessful in her attempts to dislodge the foreign body.

On examination, a cylinder blade, located within a white plastic housing, was firmly attached to the vermillion of the upper lip (Fig. 1). The child was reluctant to allow examination and refused any attempts to remove the device. It was decided that treatment under general anaesthesia would be necessary to facilitate predictable removal of the device and to allow safe management of the lip wound.

Figure 1
figure 1

Foreign body attached to child's upper lip

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An inhalational induction was administered via a nasal mask to accommodate the position of the foreign body. During examination under anaesthesia, it was obvious that it would not be possible to remove the blade unit intact without causing further tissue maceration. The blade's plastic housing was therefore disassembled using a variety of surgical instruments, including universal cross-head screwdrivers, and the lip tissue was manipulated free (Figs 2). There was a limited superficial 10 mm laceration with localised oedema, no tissue ischemia, and no necrosis. The wound was thoroughly debrided and left to heal by secondary intention.

Figure 2
figure 2

Intraoperative photograph demonstrating the disassembly of the blade housing using a surgical cross-head screwdriver

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In view of this mechanism of injury, the child was prescribed co-amoxiclav oral suspension and miconazole oromucosal gel for five days, and arrangements were made for follow-up in two weeks. It was agreed that the cause of injury in this child's case was unintentional and self-inflicted. At our outpatient review, there had been no complications, and the wound appeared to be healing well.

An internet search reveals a wide variety of battery-powered dry skin removers available for purchase. The device implicated here was rather unusual in its construction, and we have been unable to locate any similar device. Most commonly these devices appear to have an abrasive rotating roller rather than a cylinder blade.

To the best of our knowledge this presentation has not been previously described, and this case adds to the broad spectrum of oral injuries presenting in the Emergency Department.