In 1953, Lobitz and Campbell11 described a strikingly abnormal cutaneous response in patients with atopic dermatitis. When acetylcholine and its derivative methacholine (acetyl-β-methylcholine; Mecholyl) were injected intradermally, a delayed blanch of the skin was seen at the site of injection. This was in marked contrast to the erythematous wheal that developed in normal persons. The occurrence of this delayed blanch has since been confirmed by many investigators,4,14,17,19 most of whom have accepted vasoconstriction as the cause of the delayed blanch reaction.3,12,17
This unique local vascular reaction raised the question of how patients with atopic dermatitis would respond to parenteral administration of acetylcholine and its derivatives. Our study was undertaken in an attempt to answer this question. The methyl derivative of acetylcholine, methacholine, was employed because of its increased resistance to hydrolysis. Its vascular effects are those of the parent substance.14,21
Subjects and Patients.—
CLARK LL, KIERLAND RR, ROTH GM. Methacholine Chloride: Vascular Effects of Parenteral Doses in Atopic Dermatitis. Arch Dermatol. 1960;82(6):957–964. doi:10.1001/archderm.1960.01580060113018
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