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HEMORRHAGIC ERYTHEMA MULTIFORME TERMINATING FATALLY

EARL B. RITCHIE, M.D.; WELDON KOLB, M.D.

Arch Derm Syphilol. 1942;46(6):856-859.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

Sodium diphenyl hydantoinate (dilantin sodium) is a drug which has been in increasing use since 1937 for the control of chronic convulsive disorders. Its chemical structure is related to that of phenylethylhydantoin, better known as nirvanol. The latter drug is a hypnotic which at one time was used extensively in the treatment of chorea and in all cases produced a characteristic toxic erythema about the tenth or twelfth day.

Dilantin sodium is an anticonvulsant but not a hypnotic drug and produces cutaneous reactions in an estimated 5 per cent of cases.¹ The therapeutic dose for the average adult is 0.1 Gm. given orally three times daily. Merritt and Putnam¹ placed the maximum daily dose at 0.6 Gm. and warned of the continued administration of the drug in the face of cutaneous reactions, even of the mildest character.

Reactions attributable to dilantin sodium may be classified as follows:

1. Gastrointestinal System.—Nausea and vomiting are the most common reactions and are believed to be due to high alkalinity of the drug. Giving the drug at meal time avoids these reactions to some extent.
   

Author Affiliations
GALVESTON, TEXAS

From the Department of Dermatology and Syphilology, University of Texas Faculty of Medicine, service of Dr. W. F. Spiller.

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