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A 50-year-old female patient developed maculopapular exanthema after administration of corticoids on account of a cervical syndrome. Under topical therapy with different corticoids because of an allergic contact eczema, the skin lesions worsened and consecutive oral corticoid therapy again induced maculopapular exanthema. Skin tests revealed an eczematous contact allergy to the stereoisomeric corticoids dexamethasone and beta-methasone, as well as to two salts of these substances. Furthermore, allergies to other ingredients of the vehicles were detected. The various allergic clinical manifestations, the allergologically important corticoids, the test procedures and sensitization conditions are discussed in correlation with the literature.

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Human infections with Serratia liquefaciens are rare. We therefore present a patient with fistulous pyoderma due to this pathogen. The success of the therapy of Serratia infections depends on determination of the resistance and sensitivity to antibiotics. Following the tentative diagnosis of dermal tuberculosis, histological, microbiological and X-ray examinations were performed. Serratia liquefaciens was identified by culture as the only cause of the skin lesions. After therapy with sulfamethoxazole trimethoprim, the lesions disappeared.

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Chloroacetophenone (CN) is used as a tear gas for riot control and as a kind of chemical Mace against small groups or individuals. Among other side-effects, CN can evoke toxic and allergic contact dermatitis, and more rarely exanthematous or anaphylactic reactions. It is difficult to distinguish between toxic and allergic reactions both in the clinical picture of dermatitis as well as on the basis of skin test reactions. We report on a patient with allergic contact dermatitis, which first appeared 5 days after exposure to CN as a sign of primary sensitization, leading to an intense eczematous reaction in skin tests. Allergy to CN does not appear to represent a handicap in normal daily life because it is solely used as tear gas and is of little significance as regards "cross-allergies" to substances in the environment.

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A lot of substances currently used in medicine and daily life are found to induce pseudoallergic reactions. Because of practical importance intolerance to aspirin and additives as well as anaphylactoid reactions to sulfites and local anaesthetics are presented. The aetiopathological problems are not yet solved, and the differentiation from true allergic diseases is difficult. Concerning the local anaesthetics, additional side effects of other components of the solutions have to be considered. An accurate history is often worthy. Generally, it is not possible to clear up pseudoallergic reactions through skin tests, so that incremental challenge is necessary.

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A drug eruption with subcorneal pustulation is presented, occurring in a patient during treatment with eprazinone . The biopsy of the initial lesions showed changes as in pustulosis subcornealis . The aetiopathogenetic relationship between administration of eprazinone and the pustular eruption was confirmed by patch test.

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About one third of patients with anaphylactic reactions to pyrazolones showed contact urticaria induced by to at least one pyrazolone after 30-60 min in patch test. This reaction was never observed in patients with various exanthemas or allergic contact dermatitis to these medicaments. Contact urticaria in patch test was mostly caused by propyphenazone, aminophenazone, and metamizole. The suspicious pyrazolone provoked positive results in only about 70%. No correlation could be found between contact urticaria in patch test and severity of allergic history, short interval before skin test and atopic constitution.

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Thirty-four married couples with clinically unexplained infertility and normal spermiograms in all male partners were investigated for sperm antibodies by means of the sperm agglutination, sperm immobilization and sperm immunofluorescence test. In 50% of the couples, sperm antibodies were found in at least one of the partners and with at least one of the tests, e.g. ten times in the female partner alone, six times in the male partner alone, and once in both partners. The correspondance of the three tests was astonishingly low; it is assumed, therefore, that they indicate different types of antibodies. On the basis of the present investigations it is not possible to assess which type of antibody is responsible for the infertility of the female or male partner respectively. This seems only possible when the decrease of certain antibody types can be determined after a period of no antigen contact (avoidance of sperm contact) and when conception has taken place. The significance of autoantibodies against sperm in clinically healthy men with normal spermiograms remains open.

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1. By means of an indirect immunofluorescent technique with reference to Weller and Coons (1954), modified for spermatozoal immunofluorescence we found antibodies against spermatozoa in the sera of: 6 of 35 female partners of couples with unexplained infertility, 5 of 35 male partners of couples with unexplained infertility, 8 of 40 prostitutes, 8 of 18 men after orchitis and vasoresection. In contrast to these findings the sera of 20 fertile women, 25 fertile men, and 20 virgins showed negative results with the test mentioned above. 2. The site of the antigen-antibody reaction was mainly the spermatozoal tail and in the second place, the equatorial segment. 3. The immunoglobulins primarily belonged to the IgG and secondly to the IgA class. 4. Our results differ partly from the findings made by other authors perhaps on account of methodical differences. 5. The clinical relevance and associated problems are discussed.

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Spermatozoa antibodies are found uncommonly frequently in prostitutes both with regard to the spermatozoa immunofluorescence test and also sperm immobilisation. This is also true to a similar extent for the sperm immunofluorescence test in a group of women from infertile marriages, but not, on the other hand for the immobilisation test, in which the frequency of positive results in this group of women was significantly lower than in prostitutes. The outcome of comparative tests in virgins and fertile women were negative. The correlation of positive results in the sperm immobilisation test and in the sperm immunofluorescence test is strikingly small, so that a variable conclusiveness is to be assumed. Presumably, in the presence of sperm antibodies the probability of conception is reduced.

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