Selected monographs on dermatology / P.G. Unna [and others].

Date:
1893
Catalogue details

Licence: Public Domain Mark

Credit: Selected monographs on dermatology / P.G. Unna [and others]. Source: Wellcome Collection.

    483/636 (page 465)
    cellular tissue, are not infrequent results of the hypodermatic injections of the salts of quinine.1 The eruptions which follow the ingestion of quinine are multiform in character. The prevailing type of the quinine exanthem is erythematous, but every form of elementary lesion—macules, papules, wheals, vesicles, bullae, pustules, purpura, &c.—have been observed as the direct result of the administration of this drug. In a study of the eruptions produced by quinine, pub- lished in the ' New York Medical Journal/ March, 1880, I gave the result of my examination of sixty cases of quinine eruptions published within the previous ten years. Analysis of these cases shows that the different forms of the eruption were represented as follows : The erythematous form.—In thirty-eight of the sixty cases referred to the general character of the eruption was erythematous. It was further described as scarlatinal, scarlatinoid, bright red, ce measly, rubeolous, papular, erysipelatous. In most cases it appears as an efflorescence of a bright, vivid hue, disappearing on pressure, and closely resembling the rash of scarlatina. Usually it first shows itself upon the face and neck, but soon becomes diffused over the whole surface of the body; in exceptional cases it may not become generalised, or it may appear in the form of distinct red spots, which become confluent and patchy,3 and the coloration may exhibit a darker hue, resembling that of measles. The eruption promptly disappears upon the discontinuance of the drug, and is usually followed by desquamation of a branny or lamellar character. In one case desquamation continued for three months.3 1 Kobner attributes these results to the irritating effects of the older vitriolic preparations.—T. C. F. 2 Erythematous patches and discs, described as roseola, are mentioned by authors (Bouvard).—T. C. F. 3 In a case recorded by Hagan an infant was subject to attacks of erythe- matous eruptions, urticaria, &c, for three years, so that his skin became thickened and scaly. The nature of the case was unsuspected for a long time, but it was eventually discovered that the mother was in the habit of dosing the children frequently with quinine, as a preventive of various ailments. When the quinine was discontinued the eruptions ceased, the 30