Perhaps the most common dermal effect of quinin, when administered internally, is a form of hives or urticaria in which the surface is fairly covered with irregular shaped reddish colored blotches, varying in size from that of a dime to the palm of the hand. The skin is slightly elevated, has a hard, tense feel to the touch; there is usually intolerable itching and burning; sometimes the skin is so sensitive that even the slightest touch causes severe pain and feels as if a raw surface had been touched.
In other cases the eruption is in the form of a rash, similar to that seen in scarlet fever. Often there is a uniform flush of the surface of the skin as in an erythema. Quite frequently a herpetic eruption follows the administration of quinin, which may be located on the lips, ear, cheek or prepuce. I have a lady patient