A little known but highly interesting feature of fixed effects is the occurrence of extracutaneous manifestations, appearing alone or in association with a "fixed" eruption. These manifestations consist of the recurrence in situ of pains, motor or sensory disturbances, swelling, congestion and other symptoms, in tissues other than the skin or the mucous membrane. Jadassohn, Naegeli, Milian, Bargues and others1 observed such reactions after the repeated use of the arsphenamines, of bismuth and of mercury. Jadassohn 1a was the first to include these manifestations in the category of fixed effects. A detailed discussion of these reactions is contained in the excellent report by Abramowitz and Noun,2 from which I have drawn freely.
The literature is rapidly becoming voluminous with reports of the value of mapharsen as an antisyphilitic agent and of its toxic effects. Those who have had experience with the drug3 unanimously agree that it is less toxic than the arsphenamines, the commonest reactions being
MENDELSOHN HV. FIXED ERUPTION WITH AN EXTRACUTANEOUS MANIFESTATION DUE TO MAPHARSEN: REPORT OF A CASE. Arch Derm Syphilol. 1940;41(3):509–514. doi:10.1001/archderm.1940.01490090061006
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