Auditory and Histopathological Effects of Topical Mercurochrome Treatment in Rats with Tympanic Membrane Perforation.

OBJECTIVES: Topical treatment is first choice in the treatment of uncomplicated chronic otitis media. It was intended to assess auditory and histopathological safety of ototopical use of mercurochrome solution in rats with induced tympanic membrane perforation. MATERIALS AND METHODS: The study was conducted on 21 female Wistar-Albino rats which were randomly assigned into 3 groups. In all rats, perforation was performed at right tympanic membrane. Distortion product otoacoustic emissions (DPOAEs) measurements were performed at frequencies of 2000, 3000 and 4000 Hz (with L1/L2: 70 /70 dB at 2f1-f2 frequency; f2/f1 ratio: 1:22) before recovery from anesthesia and signal-to-noise ratio (SNR) were recorded. Normal saline, 2% mercurochrome and gentamicin were given to group 1, 2 and 3 twice daily over a week, respectively. Rats were sacrificed after DPOAE measurements on day 14. Right temporal bone specimens were examined under light microscope after processing. RESULTS: Based on DPOAE results, there was no significant difference among groups before treatment. On day 14, significant differences were found in DPOAE measurements at 3000 and 4000 Hz, and in mean SNR values in 2% mercurochrome and gentamicin groups when compared to normal saline group while no significant difference was detected at 2000 Hz among groups. In addition, significant degeneration was detected in Corti organs, spiral ganglions and stria vascularis in groups 2 and 3. CONCLUSION: In this study, it was observed that mercurochrome use in external otitis and otitis media with tympanic membrane perforation could cause ototoxicity and concluded that the solution should be used cautiously.

Prospective Single-Center Observational Study of the Allergenic Potential of Mercromina Film and Other Common Antiseptics in Patients With Contact Dermatitis. / Estudio observacional de seguridad, prospectivo y unicéntrico para determinar la capacidad alergogénica de Mercromina Film® y otros antisépticos de uso común en pacientes con dermatitis de contacto.

INTRODUCTION: Although Mercromina Film and other topical antiseptics are widely used, they are not included in the standard series recommended by the Spanish Contact Dermatitis and Skin Allergy Research Group for testing suspected allergic contact dermatitis (ACD). Furthermore, no recent studies have investigated the allergenic potential of merbromin. OBJECTIVE: To determine the allergenic potential of merbromin and compare it with that of other topical antiseptics widely used in clinical practice, including povidone-iodine, chlorhexidine, and eosin. MATERIAL AND METHODS: Prospective single-center observational safety study of 105 patients with suspected ACD seen at the dermatology department of our hospital. RESULTS: Of the 105 patients studied, 1.9% had a positive patch test to merbromin and 12.4% were sensitized to povidone-iodine. The differences in the proportion of patients with ACD to Betadine Solución Dérmica (povidone-iodine) compared with the rest of the antiseptics was statistically significant (McNemar test, P<.05). No adverse reactions were observed in any of the patients. CONCLUSIONS: Based on the patch tests conducted, Mercromina Film has very low allergenic potential. The highest allergenic potential was observed for povidone-iodine.

Mercurochrome allergy. Immediate and delayed hypersensitivity.

We describe eight patients suffering from Mercurochrome allergy. Patch and prick tests were carried out with the following organic and inorganic mercury compounds: thimerosal, Mercurochrome, phenylmercuric acetate, phenylmercuric nitrate, metallic mercury, and mercuric chloride, and with sodium fluorescein. Two patients had an anaphylactic reaction a few minutes after application of Mercurochrome. The prick tests with Mercurochrome were positive and they were negative with the other tested products. All patch tests were negative. In the other six patients, the clinical picture was local eczema, and the patch tests were all positive with Mercurochrome and the inorganic mercuric derivatives. Positive patch tests with thimerosal were found only in two patients, and only one had a positive patch test with salts of phenylmercury. In four patients, the prick test with Mercurochrome, negative in immediate reading, gave a late eczematous reaction.

Allergic contact dermatitis and mercury exanthem due to mercury chloride in plastic boots.

We report a 5-year-old child with previous skin intolerance from Mercurochrome (merbromin), who developed a severe allergic contact dermatitis of both feet when wearing new polyvinyl chloride (PVC) boots. Within a few days, he developed a mercury exanthem involving both legs, groins and lateral parts of the trunk. Patch tests showed strong reactions to organic and inorganic mercury compounds, in particular to mercury chloride (mercury chloride; HgCl2), 0.01% pet., which was identified by atomic absorption spectrometry and polarography in the boots worn. New hidden sources of mercury in consumer goods may represent a potential source of danger for the future, if its use is not more strictly regulated.

Hypersensitivity to mercuric fluorescein compounds.

The mercurial compounds are known to be a common cause of allergic contact dermatitis. Immediate hypersensitivity is rarely induced by mercurial organic derivatives. However, none of the published cases showed both immediate and delayed hypersensitivity as was the case of one of our two patients. A boy and a woman experienced urticaria and anaphylaxis, respectively after topical application of Merchromine (Merbromine). We were able to demonstrate immediate hypersensitivity in both patients to mercuric fluorescein compounds by skin test and histamine liberation. In addition, the child but not the woman, showed delayed hypersensitivity to mercurial compounds.

The conservative management of exomphalos major.

In 52 children with exomphalos treated over a 10 year period, the overall mortality was 31%. Death was almost invariably due to associated major congenital abnormalities. Treatment of minor exomphalos by primary closure incurred no additional mortality and minimal morbidity. Treatment of 25 children with exomphalos major by excharotics resulted in two deaths not attributable to other anomalies, one of which was a result of complications of this treatment regimen. Apart from infection, which was in general easy to control, the morbidity associated with this form of treatment was less than encountered in most reports of surgical closure.

Anaphylactic hypersensitivity to mercurochrome (merbrominum).

By the use of intradermal tests, passive transfer (P.K.), and an in vitro histamine release test, we were able to demonstrate immediate hypersensitivity to Mercurochrome in a young man who had suffered anaphylactic shock after having contact with this antiseptic. Cross-reactions among different organic mercurial compounds were observed.

Mercury exanthem.

We experienced 15 patients with generalized rash, mostly appearing a day or two after breaking a clinical thermometer or during dental treatment. Similar skin manifestations were revealed, suggestive at first glance of mercury exanthem, i.e. diffuse symmetrical erythema predominantly on major fluxural areas. An inverted triangular or V-shaped erythema on both upper antero-medial thighs was a common feature. Severe cases had miliary pustules and/or purpura on erythematous skin. Pruritus or burning sensation was relatively mild. Pyrexia or malaise was a complaint of more than half the patients. Most of the patients had a previous history of contact dermatitis to Mercurochrome, and by patch-testing were found to have contact allergy to several mercurials, especially inorganic ones. Until recently, Mercurochrome had been most widely used as a topical disinfectant in Japan. This seems to be a possible cause of the high incidence of contact allergy to mercurials in this country. From our findings we feel that our patients had developed systemic contact dermatitis due to inhalation of mercury vapor.