Fulminating Dermatitis Bullosa Medicamentosa Due to "Mesantoin"

Methylphenylethyl hydantoin ("mesantoin"), one of the most recent clinically tested anticonvulsant drugs, has been credited with considerable effectiveness in the reduction and control of grand mal seizures. It appears to be somewhat less effective in the control of psychomotor attacks and seldom effective in petit mal. Most writers have attributed one or more side effects to the use of this drug. One of these discussed was the appearance in some patients of a cutaneous rash, a reaction which is also elicited with phenobarbital, diphenylhydantoin sodium ("dilantin") and trimethadione ("tridione"), the three most commonly used anticonvulsants. Eruptions due to drugs are usually pinkish or reddish, macular and of symmetric distribution, with more or less itching and burning, and may simulate any condition or disorder.1Because this reaction is encountered with the use of phenobarbital, diphenylhydantoin sodium and trimethadione, it is interesting to study the relationship of their chemical formulas to