The exfoliated epidermis was then removed and the medicament was applied directly. The order of efficiency of these substances was found to be: (1) gentian violet, (2) mercurochrome, (3) iodine, and (4) ammoniated mercury ointment. Mercurochrome was satisfactory, but did not produce such rapid delimitation and eradication of the infection as did gentian violet. Iodine was also effective, but was frequently too irritating. Ammoniated mercury ointment was found to be detrimental to rapid healing; it was not only ineffective, but prolonged infection and favoured complications.
Gentian violet was tried, as the cause of infantile impetigo is supposed to be a strain of Staphylococcus aureus, and Churchill has shown that this dye has a selective bacteriostatic action on Gram-positive organisms, penetrating other organisms and living cells without deleterious effect. Its use was strikingly beneficial, definite improvement occurring in twelve hours and entire healing in a week. More than one application of the gentian violet is seldom necessary, there being an immediate arrest of extension.
Desiccation is rapid, and the thin crust formed permits of epithelialization under the surface, with normal desquamation of the crust in about forty-eight hours. There was a notable absence of recurrences in the cases so treated; after discharge only four patients returned for further treatment, and these showed merely minor recurrences. British Medical Journal, 29th September, 1928.
