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THE incidence of cutaneous reactions during penicillin therapy has been substantially reduced since a pure crystalline form of this drug has come into general use.1 In certain patients, however, crystalline penicillin G must be used with caution or abandoned entirely because of the appearance of unpleasant or even hazardous reactions.2 3 4 5 6 Although newer antibiotics are available, penicillin remains the treatment of choice frequently enough to warrant search for a less allergenic preparation. In the study of the biosynthesis of penicillin G many different penicillins have been produced by altering the composition of the culture media.7 , 8 Most of these are of little . . .

Four Air Force development materials were studied via the prophetic patch test method on laboratory animals to determine the primary irritant effect, gross sensitization index, and gross percutaneous toxicity of these materials. The patch test studies with rabbits indicated that one of the materials produced severe primary irritant action. Testing on human volunteers was therefore carried out with three of the materials. Results indicated that these materials were safe to use in contact with human skin.

Dyed furs and leather (shoes and hatbands) have long been recognized as causes of cutaneous toxicity. Dermatitis venenata due to idiosyncrasy to dyes in other apparel has received less attention, although this phase of the subject has been considered in articles to be mentioned later. Personal studies indicate that additional lesions may be produced by such dyes. In fact, these agents may lead to the development of photosensitivity, furunculosis and possibly hidradenitis suppurativa, lichen simplex chronicus (Vidal) and other entities. DERMATITIS VENENATA Simple contact dermatitis constitutes the most common manifestation of sensitivity to dyes. In 5 per cent of the cases of dermatitis venenata in my private practice the condition is caused by such agents. Cole, 1a as the result of a questionnaire, found that of 514 cases of dermatitis due to various dyes, cosmetics and furs, in 56, or nearly 11 per cent, the condition was caused by dyed

Nineteen of 25 patients treated with systemic bleomycin therapy developed skin toxicities such as infiltrated plaques, nodules, and bands on the hands, linear hyperpigmentation on the trunk, and gangrene of the fingertips. The association of these changes with pulmonary fibrosis, which also occurs in patients treated with bleomycin, may suggest the possibility of a drug-induced scleroderma.

To the Editor.— Several cases are presented in which contact dermatitis occurred secondary to prepackaged wound dressing material containing excessive quantities of ethylene oxide used during sterilization. Ethylene oxide is a colorless gas widely used for sterilization of medical supplies and equipment. Cutaneous toxicity of this chemical has been known for many years and has received sporadic attention. 1-3 The increasing use of ethylene oxide in sterilization of anesthesia equipment has been paralleled by increasing numbers and varieties of toxic reactions. 4 This report describes a group of cases of contact dermatitis which were traced to ethylene oxide residuals in prepackaged gauze dressings. In addition to revealing an unusual source of ethylene oxide toxicity, this experience suggested relevance to many areas of medicine. Report of Cases.—Case 1.— A 21-year-old man who was seen two days after appendectomy had noted irritation beneath the wound dressing 24 hours after surgery.