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November 1971


Author Affiliations

University of California School of Medicine at Irvine Irvine, Calif

Arch Dermatol. 1971;104(5):563-564. doi:10.1001/archderm.1971.04000230105022

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To the Editor.—  MK-672 (Merck) is the hydrochloride salt of a bicyclic base with the empirical formula C9H13Cl N6O:HCl (M.W. 293.2). The chemical name for MK-672 is: 6-chloro-5-(2-dimethylaminoethylamino)-imidazo[4,5-b]pyrazine-2- (3H) -one HCl. It is an imidazopyrazine derivative having significant antihypertensive activity in animals.In a major phase 1 clinical pharmacology double-blind controlled study in man, 12 of 19 subjects developed acneiform dermatitis as follows:Subjects developing cutaneous lesions had fine discrete papules and pustules which appeared follicular in distribution and occurred mainly on the anterior and posterior areas of the chest, upper arms, and forehead. Gram stains from one patient's pustules revealed large numbers of gram-positive pleomorphic rods (which is compatible with Corynebacterium acnes). Biopsy from one patient showed folliculitis. The onset of lesions was from 3 to 21 days; drug administration was stopped on day 24. No similar lesions were seen in prior animal studies.This drug which

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