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The incidence of contact-allergic reactions to some 10 substances out of 75 tested in 100 selected leg-ulcer patients is about 5 times as high as in eczematous patients. These substances are p-phenylenediamine, p-aminoazobenzene, Pellidol®, benzocaine, diaminodiphenylmethane, neomycin, coal tar, balsam of Peru, wool alcohols. Sesame oil was the tenth substance. It is used to clean the skin from rests of ointments. In Holland it figures as a constituent of the often-used, so-called pasta zinci oleosa, ung. diachylon, ung. simplex, and of emulgide cream. In our opinion, not only topical medicaments should be regarded as frequent contact sensitizers in leg-ulcer patients. A second class of important sensitizers in this group of patients appears to be the para-substituted substances such as p-phenylenediamine (and azo dyes) as inducers considered to be responsible for the cross-reaction of drugs such as benzocaine and sulfanilamide, and of the rubber additive, diaminodiphenylmethane. Stress is laid upon five preventive measures concerning contactants in leg-ulcer patients (stockings, bandages, topical medications) and upon the desirability of having non-sensitizing preservatives and stabilizers at one’s disposal–especially for topical medications in leg-ulcer patients who apparently are sensitized with greater ease than patients with other skin ailments.

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During the last few years a certain amount of doubt has developed especially among the dermatologists, concerning the importance of allergic factors in the pathogenesis of atopic dermatitis. New facts pushed the allergic hypothesis into the background. Moreover it appeared that the measures, which were applied most frequently by the allergists, e.g. elimination of allergens and desensitization were disappointing in their results.We think that one of the reasons for this was the lack of discrimination between the different types of allergic phenomena. The macroscopic and microscopic aspects of the skin seem to be quite different from those which we are accustomed to see after histamine liberation.Nevertheless, a certain connection between the dermatitis and the atopic syndrome must exist, both in the patient himself and in the different members of his family.A fairly considerable number of eczematous patients during the rest of their lives get respiratory complaints as is true also of many members of their family.Since the work of/-'oor/zon/^ ^r rt/. (1962) the criteria of the atopic syndrome have been defined much more sharply than before and we have more reliable test allergens at our disposal, in particular we have obtained a better idea of the concentrations to be used. We have therefore thought it important tôWe are indebted to doctor J. df fries for his help in pUinnirig the investigation and for ail the statistical analyses.

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