Skin sensitivity to penicillin preparations.

Abstract

CASE 1.—The patient, an engine-driver, aged 54, was admitted on 24 April 1947 with fl three months' history of a rash on the forearms and legs. The history and clinical picture were compatible with the diagnosis of an exogenous dermatitis. On 16 May 1947 the affected skin showed evidence of secondary infection and was treated with Penicillin Cream B.P. By the next day the arms and legs showed a severe weeping eczematous reaction. On treatment with a simple lead lotion this condition gradually subsided, and the skin had almost healed by 23 May 1947. On this day he developed a thrombophlebitis of the right basilic vein with surrounding cellulitis, and treatment with intramuscular injections of sodium penicillin, 50,000 units three-hourly, was begun. After 36 hours there appeared a pink maculopapular rash on the trunk and limbs. Penicillin treatment was stopped and Benadryi, 50 mg. q.i.d., was given orally for three days, by which time the rash had completely subsided. In view of the reaction of the skin to Penicillin Cream and the general reaction to parenterai penicillin, it was decided to carry out tests of skin sensitivity to penicillin solution and Penicillin Cream. The composition of the latter is as follows :