A Cutaneous Test for Rheumatic Activity in Children

Summary 1. Inunction with an ointment containing 5% tetrahydrofurfuryl ester of nicotinic acid (Trafuril) in 337 children caused localized cutaneous hyperemia and/or edema (“typical” reaction) in normal subjects and those with congenital heart disease or non-rheumatic conditions. 2. Twenty of 22 patients with active rheumatic disease failed to show this typical hyperemia or edema. Their response (“atypical”) consisted of either blanching, failure to react, or barely perceptible hyperemia. 3. Inactive rheumatics and patients whose activity was suppressed by cortisone or aminopyrine gave typical reactions. 4. The atypical response was observed in tonsillitis and streptococcal sore throat, as well as rheumatic activity.