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.