For almost two decades sodium thiosulfate has been accepted as the drug of choice in the treatment of arsenical dermatitis. Although dissenting opinion has existed throughout this period, it has never achieved widespread attention. More recently, however, the literature has emphasized the scarcity of evidence favoring the use of this drug. Chargin,1 in particular, has voiced the doubt of an important group of dermatologists as to the value of sodium thiosulfate for any of the manifestations of arsphenamine toxicity.
One of the reasons given for thinking that sodium thiosulfate is beneficial in arsenic poisoning is based on Osborne's studies2 of the behavior of certain crystals in the skin which he believed to be arsenic trisulfide. Montgomery and Waisman3 stated the belief that their investigations confirmed Osborne's findings. These crystals have been noted by others4 in the tissues both of normal persons and of persons with arsenical
ABRAMOWITZ EW, MATTICE MR, BOTVINICK I. DOUBTFUL VALUE OF SODIUM THIOSULFATE IN THERAPY OF ARSENICAL DERMATITIS. Arch Derm Syphilol. 1943;47(2):175–184. doi:10.1001/archderm.1943.01500200019002
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