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Article
October 1943

FIXED DRUG ERUPTION PRODUCED BY DIPHENYLHYDANTOIN SODIUM

Arch Derm Syphilol. 1943;48(4):413-414. doi:10.1001/archderm.1943.01510040057011
Abstract

Diphenylhydantoin sodium (phenytoin sodium; dilantin sodium [sodium 5,5-diphenyl-hydantoinate]) has been used extensively both in the United States and abroad in the control of chronic convulsive disorders since it was first introduced by Merritt and Putnam in 1937.1 Most observers are enthusiastic regarding the anticonvulsant merits of the drug, but nearly all emphasize the high incidence of toxic reactions. These may affect the gastrointestinal, the central nervous, the hemopoietic, the cardiovascular or the cutaneous system. Fairly frequently, reactions are noted concurrently in more than one system.

Lesion on arm showing fixed pigmentary eruption.

A large variety of cutaneous reactions have been attributed to the drug. The incidence of cutaneous signs of toxicity differs widely, from 0 or 1.3 to 35 per cent, although most observers estimate the incidence of cutaneous eruptions to range from 5 to 12 per cent.

The types of cutaneous reactions differ considerably. While erythema

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