Burns 25 (1999) 465±466

Central palatal burns associated with the eating of microwaved

pizzas
O. Nahlieli a,*, E. Eliav a, Y. Shapira a, A.M. Baruchin b,c
a
Maxillofacial Unit, Barzilai Medical Centre, 78306 Ashkelon, Israel
b
Plastic Surgery Unit, Barzilai Medical Centre, 78306 Ashkelon, Israel
c
Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheba, Israel
Accepted 14 December 1998

Abstract

Burns of the oral mucosa can be caused by heat, cold, radiation, electricity and mechanical or chemical stimuli. Acids, alkalis
and salts can cause considerable damage to the oral mucosa, membranes and lips. Most damage is found in the oropharynx,
besides the pharynx and tonsils, the alveolar mucosa of the tongue and the masticatory mucosa of the palate or gingiva show
localized or di€used damage. The clinical appearance depends on the severity of the tissue damage and the destructive properties
and mode of application of the causative agent. We present an illustrative case of central palatal burn associated with the eating
of microwaved pizzas and discuss similar mechanisms of injury. # 1999 Elsevier Science Ltd and ISBI. All rights reserved.

Keywords: Burns; Microwave

1. Introduction
Central palatal burns associated with the eating of
microwaved pizzas are being seen more frequently.
Similar burns were observed after a contact with the
heated ®lling of jelly-®lled or cream-®lled pastry. These
lesions usually appear as centrally located whitish gray
or ulcerated lesions on the middle third of the hard
palate. The patient is usually unaware of the cause of
the lesion until a careful history is taken. The super-
®cial necrosis or ulceration results from a combination
of the hot heat-holding cheese and the spices that com-
prise an otherwise desirable feature of this popular
food (likewise, the glaze and the jelly in the ®lled pas-
try).
2. Case report
A 40-year-old woman was seen in our outpatient
* Corresponding author.
clinic for a painful burn in her palate which she devel-
oped few hours after eating a microwaved pizza. On
examination a circumscribed reddish-brown blister
measuring 2.5  1.5 cm with sloughing white lesion of
the mucosa adjacent to it, was noted (Fig. 1). The
patient was treated by the application of triamcinolone
in Orabase and a bland diet. The burn healed within a
week.
3. Discussion
Mild thermal burns of the oral tissues arise from the
accidental ingestion of hot foods or beverages [1].
These are usually of little consequence, since they are
of relatively short duration and involve comparatively
small areas. The anterior third of the tongue and the
palate are common sites of burns caused by hot food
and beverages. The microwave has been associated
with an increased frequency of thermal-burns because
of its ability to produce a food that is cool on the out-
side but extremely hot in the interior [1±3]. Perlman [4]
presented a case of an adolescent who sustained a

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466 O. Nahlieli et al. / Burns 25 (1999) 465±466

Table 1
Microwave heating of ®lled pastry. After Maley [2]

Item Start temp (8C) Time (s) Filling (8C) Pastry (8C)

Jelly-®lled 238 30 968 908

Cream-®lled 238 30 878 798
Roll w/jelly 238 30 1018 948

to transfer heat. The jelly (or cheese in our case) will

transfer heat to the mucosa very rapidly while the pas-
try portion of the doughnut or pizza (heated to almost
the same temperature) does not `feel' as hot. The tem-
perature of the various parts of a jelly ®lled, cream-
®lled or pizzas can become very high in only a short
period of time [4] (Table 1). The potential for burns, in
relation to the use of the microwave oven is not
strictly equal to that of the conventional stove or
oven, however a risk does exist [5]. Di€erential heating
of food, especially frozen items may result in one area
being very hot and another portion remaining cold or
frozen. In case of ®lled pastry, the pastry while hot
will not transfer heat to the oral tissues at the same
rate as the glaze cheese or ®lling thus one is led to
believe the item is not hot enough to cause a burn
until it is too late.

Fig. 1. Central palatal burn associated with the eating of a micro-
waved pizza. Zone of white epithelial necrosis, blister and erythema
of the palate are noted.
burn after heating (in the microwave oven) a frozen
jelly-®lled doughnut. The problem is related to the
di€erential heating which occurs when a frozen pro-
duct is warmed in the microwave or is associated with
the di€erences in the ability of various substance and
References
[1] Baruchin AM, Lustig PJ, Nahlieli O, Neder A. Burns of the oral
mucosa 1991;19:95±6.
[2] Maley HP. Burns from microwave ovens. Lancet 1986;1:1147±8.
[3] Lynch MA. In: Burket's Oral Medicine, 7th ed. Philadelphia:
Lippincott, 1977. p. 69.
[4] Perlman A. Hazards of a microwave oven. New Eng J Med
1980;302:970.
[5] Godwin Y. Egg on your face. Burns 1998;24:585±6.