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March 8, 1941


Author Affiliations

Professor and Chairman of the Department of Medicine, Loyola University School of Medicine; Attending Physician and Chairman of the Pneumonia Committee, Cook County Hospital; Resident Physicians, Pneumonia Service, Cook County Hospital CHICAGO
From the Cook County Hospital and the Department of Medicine. Loyola University School of Medicine.

JAMA. 1941;116(10):938-940. doi:10.1001/jama.1941.02820100032007

The introduction of the newer chemotherapeutic drugs has produced several clinical patterns of toxic manifestations. These effects are encountered in several organs and tissues of the body. One of the most common of these is the untoward reaction encountered in the skin. Indeed, if the nausea and vomiting induced by sulfapyridine are eliminated from consideration, cutaneous rashes are probably the most frequent toxic reaction.

Attention has been directed repeatedly to these cutaneous manifestations with the use of sulfanilamide and sulfapyridine. Experience indicates the former as the more frequent offender in this regard. For example, the types of rashes encountered are indicated by such varied descriptions as erythematous, morbilliform, maculopapular, erythema multiforme, vesicular, bullous, urticarial, exfoliative and purpuric. On the other hand, rashes produced by sulfapyridine have been infrequent. The morbilliform eruption is most commonly encountered on sulfanilamide administration. Nevertheless, specific rashes probably cannot be ascribed to the specific sulfanilamide drug. There may be an exception to this statement because we have encountered a nodular type of rash only with the use of sulfathiazole.

Sulfathiazole, 2-sulfanilamidothiazole, has been recently introduced as an addition to the chemotherapeutic armamentarium. The advantages of this