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War Surgery and Medicine

Sensitisation to Sulphonamides and Penicillin

Sensitisation to Sulphonamides and Penicillin

As with the sulphonamides, cases of contact dermatitis followed the local application of penicillin. After incubation periods of five to seven days some patients developed dermatitis, which cleared when the penicillin application was stopped. Reapplication of penicillin caused an immediate recurrence. Penicillin, therefore, presented a similar allergic problem as did the sulphonamides—namely, that the local application of a life-saving chemotherapeutic agent for trivial skin conditions can set up sensitisation which hinders its subsequent use for serious infections. With penicillin, however, the sensitivity of such cases to injections appeared to be lower than was the case with sulphonamides. The contra-indications to its local use were therefore less obvious, but the occurrence of these sensitivities indicated that the drug should not be applied to the skin for periods longer than three to four days at a time.

In 1945 cases were still seen from time to time in 2 NZEF of sensitisation dermatitis produced by local application of sulphonamide. In the British forces its use for these purposes was prohibited, but it seemed that some of the newer New Zealand RMOs were still unaware of this state of affairs. By this time the knowledge of the local use of sulphonamides on the skin had advanced. It was found possible to apply them to cutaneous lesions without danger of sensitisation, so long as a small dose was given simultaneously by mouth.

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