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Streptomycin, cause of dermatitis venenata in a nurse. Report of case
AES1’RACTS
OF
CURRENT‘
LITERATURE
9%
This subsided within a few days, but on the next visit to defined patches of ergthema. appeared in the same areas within the dentist, for the same purpose, a similar eruption The patient had a past history of sensitivity to mercury extending twenty-four hours. The last episode of mercurial dermatitis occurred five years over a period of ten years. previously after the use of ammoniated mercury ointment.
‘ ‘Examination.--There was a pinkish edematous ill defined eruption involving the The following items were used in patch tests chin and anterior portion of the neck. (1) metallic mercury, with a positive and the reactions read in forty-eight hours: reaction with edema, erythema and vesiculation, and (2) mercury amalgam, with a positive reaction with edema, erythema and vesiculation. Severe edematous vesicular dermatitis appearetl on the arm where the tests lvere made, beginning forty-eight hours after the patches had been removed, and sprratl to involve the entire arm and asilla. This eruption lastetl one week. ” Summary and Conclusions “Two cases of contact dermatitis from use of mercury amalgam fillings are described. The dermatitis in both instances was confined to the perioral area, face and neck. Patch tests to metallic mercury, fresh mercury amalgam and silver alloy were done. Positive reactions to patch tests were observed only to mercury and the mercury amalgam. 111 such patients, recourse must be had to the use of gold or cement fillings, as mercury is definitely contraindicated. ’’ T. J. C.
Streptomycin, Cause of Dermatitis Venenata in a Nurse. Report of a Case. Sture A. M. Johnson and Helen Pratt Davis. Arch. Dermatol. & Syph. 59: 243, February, 1949. “IL E. B., a 34 year old graduate nurse, was admitted to the department of dermatology and syphilology on May 5, 1947, complaining of a dermatitis of the fingers of three weeks’ duration as well as pruritus of the face. Questioning revealed that she had noticed a mild generalized pruritus for several weeks before the onset of the localized eruption. The past history of diseases revealed occasional attacks of mild urtiearia. The dermatologic examination revealed fissuring, erythema, swelling and weeping of the fifth finger of the right hand and of the third finger of the left hand. Local therapy with wet dressings was instituted with some benefit. Suddenly, four days later, there appeared pronounced swelling, scaling, crusting and erythema about both eyes. The left eye was swollen completely shut. The dermatitis of the two hands was no longer limited to the two fingers but was present on all the fingers. After being off duty for ten days, the condition about the eyes cleared except for slight scaling and pigmentation, and the hands improved. At this time a diagnosis of dermatitis venenata was made, and the patient was referred to the department of allergy, where patch tests were done with soaps and medicaments used on the floor. At the end of twenty-four and forty--eight hours, only the reaction to the patch test with streptomycin was positive. At this time it was determined that for six months the uurse not only lrad made solutions of various lots of streptomycin but also had administered it intramuscularly and by aerosol. On return to duty she gave no streptomycin the first day and remained clear. On the second day she gave one injection of the antibiotic, and within three hours her eyelids Pruritis and dermatitis of the hands started to reappear at the began to itch and swell. same time. She again went off duty for a week with improvrmeut in her condition. At this time, patch tests with serial dilutions of streptomycin mere made. In t,wenty-four hours, results of patch tests were positive up to the 1 :lOO dilution and in forty-eight hours up to There was a recurrence of generalized pruritus while the patch tests the 1: 1000 dilution. were on the skin. The nurse was then placed on duty in another building where all contacts Her skin continued to clear, and there was no remained the same except for streptomycin. Later attempts to place this nurse back on duty administering recurrence in one month,
streptomycin have caused new acute flare-ups of dermatitis who had daily contact with streptomycin were given patch drug. All had negative results.”
Authors’
venenata. tests with
Eleven other nurses the same lot of the
Comment
‘(Streptomycin was found to be the cause of acute dermatitis venenata of the hands and the eyes of a nurse who had administered solutions of the drug for six months before any real symptoms of cutaneous sensitivity became apparent. Individual sensitivity was demonstrated by strongly positive reactions to patch tests on the patient contrasted with negative results of patch tests in eleven nurses who also handled the antibiotic under similar conditions. Removing the nurse from the floor gave immediate relief. Allowing her to resume her previous duties caused new flare-ups, It is hoped that this case report will alert users of the drug to the potentialities of dermatitis venenata. ‘? T. J. C.
Ueber die lokale Fluorapplikation zur Karies-prophylaxe und ihre statistische Auswertung mit dem “Berner Kariesindex.” K. TschBppM. Hchweiz. Monatschr. f. Zahnh. 58: 961, 1948. The author evaluates the experiments conducted in the United States in the field of caries prophylaxis by topical fluoride application, and submits the results of his own inTwo hundred thirteen school children aged 1 2 to 14 were submitted to fluoride vestigations. treatments; the substances used were 1 per cent sodium fluoride solution and a compound produced by Leimgruber containing sodium fluoride and a synthetic enamel-building factor (sulfur and nitrogen components which, during the hardening process of the erupting tooth, are derived from the saliva). The effect of one as against two treatments was compared, and it could be shown that the percentage of caries reduction was in close accordance with The Leimgruber compound, however, the data of similar experiments of American authors. No treatment is completely successful ; proved even more effective throughout the experiments. failures have been observed in all groups. The statistical calculations were made by using a new formula for the caries index (Berne caries index). It has the advantage of evaluating the different tooth surfaces according to their caries disposition. This increases considerably the exactness of large statistics. R. H. B.
Les Manifestations Buccales d’Intol6rance aux Resines Methacryliques. (Oral Manifestations and Intolerance to Acrylic Resins.) M. Dechaume and M. Brunei, Paris. Rev. de stomatol.
49: 700, 1948.
The authors
conclude from the cases they have studied that the intolerance to dentures resins is due to a defective product which causes in susceptible patients a stomatitis. They believe that it is the coloring material used which causes the local and In order to avoid such react,ions from new materials, one should know regional reactions. the chemical composition of new products. K. H. T.
made of acrylic
Use of Vitamin A in the Treatment of Cutaneous Diseases. Relation to Estrogen and the Vitamin B Complex. Frances Keddie. Arch. Dermat. & Syph. 58: 64, July, 1948. Vitamin A is extracted from natural sources and reduced to crystalline form. In the It is almost completely absorbed from the human organism, vitamin A is stored in the liver. human intestinal tract under normal conditions. It is felt that utilization of vitamin
there A.
is a relationship
between
the patient’s
endocrine
status
and the
OF
CURRENT‘
LITERATURE
9%
This subsided within a few days, but on the next visit to defined patches of ergthema. appeared in the same areas within the dentist, for the same purpose, a similar eruption The patient had a past history of sensitivity to mercury extending twenty-four hours. The last episode of mercurial dermatitis occurred five years over a period of ten years. previously after the use of ammoniated mercury ointment.
‘ ‘Examination.--There was a pinkish edematous ill defined eruption involving the The following items were used in patch tests chin and anterior portion of the neck. (1) metallic mercury, with a positive and the reactions read in forty-eight hours: reaction with edema, erythema and vesiculation, and (2) mercury amalgam, with a positive reaction with edema, erythema and vesiculation. Severe edematous vesicular dermatitis appearetl on the arm where the tests lvere made, beginning forty-eight hours after the patches had been removed, and sprratl to involve the entire arm and asilla. This eruption lastetl one week. ” Summary and Conclusions “Two cases of contact dermatitis from use of mercury amalgam fillings are described. The dermatitis in both instances was confined to the perioral area, face and neck. Patch tests to metallic mercury, fresh mercury amalgam and silver alloy were done. Positive reactions to patch tests were observed only to mercury and the mercury amalgam. 111 such patients, recourse must be had to the use of gold or cement fillings, as mercury is definitely contraindicated. ’’ T. J. C.
Streptomycin, Cause of Dermatitis Venenata in a Nurse. Report of a Case. Sture A. M. Johnson and Helen Pratt Davis. Arch. Dermatol. & Syph. 59: 243, February, 1949. “IL E. B., a 34 year old graduate nurse, was admitted to the department of dermatology and syphilology on May 5, 1947, complaining of a dermatitis of the fingers of three weeks’ duration as well as pruritus of the face. Questioning revealed that she had noticed a mild generalized pruritus for several weeks before the onset of the localized eruption. The past history of diseases revealed occasional attacks of mild urtiearia. The dermatologic examination revealed fissuring, erythema, swelling and weeping of the fifth finger of the right hand and of the third finger of the left hand. Local therapy with wet dressings was instituted with some benefit. Suddenly, four days later, there appeared pronounced swelling, scaling, crusting and erythema about both eyes. The left eye was swollen completely shut. The dermatitis of the two hands was no longer limited to the two fingers but was present on all the fingers. After being off duty for ten days, the condition about the eyes cleared except for slight scaling and pigmentation, and the hands improved. At this time a diagnosis of dermatitis venenata was made, and the patient was referred to the department of allergy, where patch tests were done with soaps and medicaments used on the floor. At the end of twenty-four and forty--eight hours, only the reaction to the patch test with streptomycin was positive. At this time it was determined that for six months the uurse not only lrad made solutions of various lots of streptomycin but also had administered it intramuscularly and by aerosol. On return to duty she gave no streptomycin the first day and remained clear. On the second day she gave one injection of the antibiotic, and within three hours her eyelids Pruritis and dermatitis of the hands started to reappear at the began to itch and swell. same time. She again went off duty for a week with improvrmeut in her condition. At this time, patch tests with serial dilutions of streptomycin mere made. In t,wenty-four hours, results of patch tests were positive up to the 1 :lOO dilution and in forty-eight hours up to There was a recurrence of generalized pruritus while the patch tests the 1: 1000 dilution. were on the skin. The nurse was then placed on duty in another building where all contacts Her skin continued to clear, and there was no remained the same except for streptomycin. Later attempts to place this nurse back on duty administering recurrence in one month,
streptomycin have caused new acute flare-ups of dermatitis who had daily contact with streptomycin were given patch drug. All had negative results.”
Authors’
venenata. tests with
Eleven other nurses the same lot of the
Comment
‘(Streptomycin was found to be the cause of acute dermatitis venenata of the hands and the eyes of a nurse who had administered solutions of the drug for six months before any real symptoms of cutaneous sensitivity became apparent. Individual sensitivity was demonstrated by strongly positive reactions to patch tests on the patient contrasted with negative results of patch tests in eleven nurses who also handled the antibiotic under similar conditions. Removing the nurse from the floor gave immediate relief. Allowing her to resume her previous duties caused new flare-ups, It is hoped that this case report will alert users of the drug to the potentialities of dermatitis venenata. ‘? T. J. C.
Ueber die lokale Fluorapplikation zur Karies-prophylaxe und ihre statistische Auswertung mit dem “Berner Kariesindex.” K. TschBppM. Hchweiz. Monatschr. f. Zahnh. 58: 961, 1948. The author evaluates the experiments conducted in the United States in the field of caries prophylaxis by topical fluoride application, and submits the results of his own inTwo hundred thirteen school children aged 1 2 to 14 were submitted to fluoride vestigations. treatments; the substances used were 1 per cent sodium fluoride solution and a compound produced by Leimgruber containing sodium fluoride and a synthetic enamel-building factor (sulfur and nitrogen components which, during the hardening process of the erupting tooth, are derived from the saliva). The effect of one as against two treatments was compared, and it could be shown that the percentage of caries reduction was in close accordance with The Leimgruber compound, however, the data of similar experiments of American authors. No treatment is completely successful ; proved even more effective throughout the experiments. failures have been observed in all groups. The statistical calculations were made by using a new formula for the caries index (Berne caries index). It has the advantage of evaluating the different tooth surfaces according to their caries disposition. This increases considerably the exactness of large statistics. R. H. B.
Les Manifestations Buccales d’Intol6rance aux Resines Methacryliques. (Oral Manifestations and Intolerance to Acrylic Resins.) M. Dechaume and M. Brunei, Paris. Rev. de stomatol.
49: 700, 1948.
The authors
conclude from the cases they have studied that the intolerance to dentures resins is due to a defective product which causes in susceptible patients a stomatitis. They believe that it is the coloring material used which causes the local and In order to avoid such react,ions from new materials, one should know regional reactions. the chemical composition of new products. K. H. T.
made of acrylic
Use of Vitamin A in the Treatment of Cutaneous Diseases. Relation to Estrogen and the Vitamin B Complex. Frances Keddie. Arch. Dermat. & Syph. 58: 64, July, 1948. Vitamin A is extracted from natural sources and reduced to crystalline form. In the It is almost completely absorbed from the human organism, vitamin A is stored in the liver. human intestinal tract under normal conditions. It is felt that utilization of vitamin
there A.
is a relationship
between
the patient’s
endocrine
status
and the