Dermatitis herpetiformis; note regarding treatment.

During 1952 I treated a 54-year-old man who presented an extensive and very pruriginous dermatitis herpetiformis which was of six years' duration. It involved the scalp, the shoulders, the buttocks, the arms, and the legs. In spite of the recognized form of treatment, which included autohemotherapy, sulfapyridine, superficial x-ray radiations, and topical mentholized lotion applications, no improvement was noted. (Elsewhere previously he was given arsenic by mouth, both in the form of potassium arsenite [Fowler's solution] and the Asiatic pill [containing arsenous acid and black pepper] to the point of toleration, without relief.) When 12 weeks of the above treatment produced no significant change, I stopped it. Everything was discontinued. The patient was vaccinated with smallpox vaccine. The vaccination caused a severe local and a general reaction, and it was followed by a dramatic amelioration of the itching and also of the objective symptoms. At the end of two