Drug absorption through the skin: blessing

1 ArchivesofDiseaseinChildhood,1987,62,220 -221 ,themainstayoftreatmentindermatology, , 'Thesuperficiallayersoftheepidermis,thes tratumcorneum,providealmostalltheskin'sb arrierproperties.(Thebasalepidermallayer sandtheunderlyingdermisarereadilypermeab le-theoftenusedterm'transdermalabsorptio n'isinaccurate.) , (below800daltons) :occludingtheepidermisincreasesitswaterc ontent, ,whereasdistribution,metabolism, (particularlyeczema) , , , ,visitingmedicalofficerattheMaryleboneWo rkhouse,London, (ananilinedye)wasbeingabsorbedtocausecya nosis(methaemoglobinaemia).Hismes-sagewe ntunheededandatleastninefurtheroutbreaks ofmethaemoglobinaemiacausedbyabsorptiono fanilinedyeshavebeenreported, , , , (withpolymixinandbacitracin), on June 22, 2022 by guest. Protected by Dis Child: first published as on 1 March 1987. Downloaded from ,withacharacteristicintramyelinoedemaand vacuolation, ,however,itwasclearthatabsorptionwasmuch greater, (itshouldhavecontainednone).Altogether20 4infantswerepoisoned,withanillnesscharac terisedbyasevereulceratingnappyrash,feve r,convulsions,andcoma, , borneinmindbystaffwhocareforinfantsbelow 28weeks' ; , ,aeutecticmixtureof2-5%lignocaineand2-5% prilocaineasanoilwateremulsion, (EMLA cream,AstraPharmaceuticalsLtd) (about 1atime), ,nitroglycerineforan-gina,hyoscinefortra velsickness,clonidineforhypertension,and oestrogensforreplacementther-apy(onlynit roglycerinisavailableintheUnitedKingdom) .

2 Thedrugdeliverysystemisintheformofanadhe sivepatch,containing(fromtheoutsidetothe skinsurface)anocclusivebacking,areservoi rofthedrug,amicroporousmembrane, , ,requiringlessfrequentdosagethanoraladmi nistration,producesmorepredictableandcon stantbloodconcentra-tions,canbetakenbyvo mitingpatients, ,mostdrugsgivenchronicallytochildren(ant iconvulsants,antibiotics,andbronchodilat ors) ,whichcouldnotbegiventopicallytoachild, , ,VanScottEJ,StoughtonRB, :Appleton-Century-Crofts, , ' ;102 ; ,LeechRW, ;34 ,LebretonR, , :2 , :anuisanceb> ;283 ,RutterN,HadgraftJ, ;107 ,CityHospital,NottinghamNG72UH on June 22, 2022 by guest. Protected by Dis Child: first published as on 1 March 1987. Downloaded from