Mercury antiseptics


Widely used antiseptics: mercurochrome, thiomersal, phenylmercuric acetate.
 
Incidence
Systemic reactions are uncommon. Delayed cutaneous reactions are common.
 
Clinical manifestations
General: anaphylactic shock.
 
Respiratory: bronchospasm.
 
Cutaneous: acute urticaria, facial edema, contact dermatitis.
 
E.N.T.: laryngeal edema.
 
Diagnostic methods
  • Prick and intradermal tests with mercury chloride, mercury nitrate, phenylmercury acetate, mercurochrome, thiomersal, thiosalicylic acid. Results may be positive following an acute reaction.
     
  • Patch-test may be positive in patients with contact dermatitis (thiomersal).
Mechanisms
IgE-mediated hypersensitivity may be implicated in immediate reactions. One positive Prausnitz-Küstner test has been reported.
 
Cell-mediated hypersensitivity in patients with contact dermatitis.
 
Management
Avoid use.
 
In addition to products for external use, some vaccines also contain mercury antiseptics (antituberculosis, antihepatitis B).

References

  1. A. Torres, "Anaphylactic hypersensitivity to mercurochrome (merbrominum), "Ann. Allergy, 1985, 54, 230–232.
  2. S. Rietschel, "Ocular inflammation in patients using soft contact lenses", Arch. Dermatol., 1982, 118, 147–148.

As in all diagnostic testing, the diagnosis is made by the physican based on both test results and the patient history.