H20 Gin or tonic: the dermatological hazards of cocktail-based quinine

Abstract Derived from Cinchona tree bark, quinine was first found to be beneficial health by indigenous Amazonian peoples. Seventeenth-century Jesuit missionaries sent the bark and seeds back Europe, where word of its therapeutic properties spread. Quinine promoted as an antiseptic treatment for a range ailments 1600s onward, including septicaemia, erysipelas scarlet fever. The dermatological risks quickly became recognized, with Bartholow stating in his 1876 work that ‘The action quinia has occasionally been attended appearance eruption on skin. Sometimes exanthem form erythema, sometimes it assumed urticaria.’ pharmacological were exploited colonial institutions such East India Company, who combined pragmatic approach antimalarial prophylaxis British penchant aperitivos. bitter taste tonic water led addition water, sugar, lime gin, giving rise gin (G&T). Its enduring popularity is, part, due astringent nature acidic content acts ‘stomachic tonic; promote appetite, flow gastric juice, digestive power’. However, since advent, G&T attributed many cases malaise, discovered this systemic review published PubMed SCOPUS literature. To adage ‘new drugs, new eruptions’, no exception. skin reaction dates 1955, occurring shortly after patient cocktail party which they developed ‘a burning sensation groins hands feet’ progressive oedema erythema these areas, spreading involve nearly all body. Other describe (in decreasing frequency) fixed drug eruptions, photosensitive reactions, allergic urticaria lichenoid reactions triggered G&Ts. spectrum eruptions extends Stevens–Johnson syndrome/toxic epidermal necrolysis scotch consumed at patient’s peril during convention 1972. With spanning two centuries, declaration Churchill ‘the saved more Englishmen's lives, minds, than doctors Empire,’ is vital dermatologists are aware potential hazards G&T.