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JAMA 100 Years Ago
March 10, 2004

CONCERNING MERCURIAL EXANTHEMATA AND IDIOSYNCRASY TO MERCURY.

JAMA. 2004;291(10):1272. doi:10.1001/jama.291.10.1272-a

Considering the fact that, if all forms of the drug are included, mercury is one of the most frequently used medicaments in the Pharmacopeia, it is of great importance to recognize the skin lesions produced by it. It is only recently that we have appreciated that not only the use of mercury by the skin, but also its internal and subcutaneous administration, may lead to cutaneous lesions which closely resemble certain of the exanthemata or specific skin diseases.

In a recent article, Tomasczewski1 reviews the question of the mercurial exanthemata, illustrating his points by cases of his own, and by others cited from the literature. His views regarding the importance of certain conditions underlying mercurial skin lesions are somewhat at variance with general opinion. He points out that the method of application of the mercury is of minor importance, and that exanthemata may be produced by the oral, hypodermic or dermic administration of the drug. He qualifies this statement by admitting that in applying the drug externally more of it is necessarily brought into contact with the skin than is the case when the oral or subcutaneous methods are used. It has been generally held heretofore that the internal administration of mercury did not cause exanthemata. In considering individual idiosyncrasies he follows Jadassohn in holding that there are two classes of individuals subject to toxic eruptions—those who have a general hypersensitiveness of the skin, in whom any irritating substance will produce skin lesions, and those who have a special or specific hypersensitiveness to certain drugs which are not necessarily of an irritating nature.

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