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In the period 1987-1990, 999 patients suspected of a contact allergy were patch-tested with Kathon CG 100 ppm active ingredients aq. Of these patients, 84 (8.4%) showed a positive reaction (70% females). In 62% of these cases clinical relevance was established. Most of them suffered from contact dermatitis of the face, the hands or the perianal region.

2 patients with typical clinical and histological pictures of hyperkeratosis lenticularis perstans were described. Both patients showed abnormalities of the mucosal surface. The ultrastructural findings, both in the cutaneous and in the mucosal lesions, provide strong evidence that the mucosal abnormalities are a real component of hyperkeratosis lenticularis perstans.

Glutathione was estimated in 98 blood samples from dermatological patients; in only two cases, both of contact eczema, a value considerably below normal was found. Glutathione reductase was assayed in blood samples from 139 different patients and 21 normal controls. The activity was significantly higher in atopic dermatitis (17patients). A significantly greater variability was found among patients with non methotrexate-treated psoriasis (44), light sensitivity (12) and scleroderma (5). In the methotrexate-treated psoriatic group (24) the mean and variability did not differ significantly from normal. In most hospitalized patients a low glutathione reductase activity rose within a few weeks, but in a case of dermatitis herpetiformis a very low level persisted for 3 months. Blood samples with very low glutathione reductase activity, taken from a case of psoriasis and from a patient on griseofulvin treatment, gave a positive peroxide test and tended to hemolyze; these returned to normal together with the glutathione reductase activity.

The incidence of contact-allergic reactions to some 10 substances out of 75 tested in 100 selected leg-ulcer patients is about 5 times as high as in eczematous patients. These substances are p-phenylenediamine, p-aminoazobenzene, Pellidol®, benzocaine, diaminodiphenylmethane, neomycin, coal tar, balsam of Peru, wool alcohols. Sesame oil was the tenth substance. It is used to clean the skin from rests of ointments. In Holland it figures as a constituent of the often-used, so-called pasta zinci oleosa, ung. diachylon, ung. simplex, and of emulgide cream. In our opinion, not only topical medicaments should be regarded as frequent contact sensitizers in leg-ulcer patients. A second class of important sensitizers in this group of patients appears to be the para-substituted substances such as p-phenylenediamine (and azo dyes) as inducers considered to be responsible for the cross-reaction of drugs such as benzocaine and sulfanilamide, and of the rubber additive, diaminodiphenylmethane. Stress is laid upon five preventive measures concerning contactants in leg-ulcer patients (stockings, bandages, topical medications) and upon the desirability of having non-sensitizing preservatives and stabilizers at one’s disposal–especially for topical medications in leg-ulcer patients who apparently are sensitized with greater ease than patients with other skin ailments.

The phenomenon of lichenoid eruptions following medication with anti-malarial, anti-arthritis and antibacterial medication is well documented in the literature. We report here the first case to be described as a result of anti-arthritis treatment with penicillamine, together with some biochemical studies of the effect of this compound on the enzyme glucose-6-phosphate dehydrogenase.