Laxative-induced contact burns from accidental ingestion of senna in a 2-year-old female.

Senna (sennosides) is a natural stimulant laxative containing anthraquinone glycosides, commonly used to treat constipation. We present the case of a healthy 2-year-old female (~12.5 kg) who is not yet toilet-trained and accidentally ingested a single 15 mg chocolate-flavored sennoside chew (1.2 mg/kg). This led to sharply demarcated erythema, pain, and blisters in her diaper area. In the emergency department, the blisters were treated by unroofing, topical mupirocin application, a petrolatum dressing, and a 5-day course of oral cephalexin. The burn injury healed without complications at a follow-up visit. This case highlights the risk of senna-induced burns in diapered toddlers, as prolonged stool-skin contact can cause blistering that mimics abusive injury. Inquiries about sennoside use should be made when perineal burns are observed in pre-continent children to prevent misdiagnosis of child abuse. Preventive measures, including caregiver education, child-resistant packaging, and safe medication storage, are essential.