title: Four cases of recurrent pseudo-scarlet fever caused by phenathrene alkaloids with a 6-hydroxy group (codeine and morphine).
abstract: Four patients with a clinical picture resembling that of scarlatina are described. This clinical picture was found to be based on a delayed-type allergy for codeine and morphine. Investigation showed that the codeine or morphine allergy is essentially dependent on the hydroxyl group at the 6 position of the basic phenanthrene structure but only when this group is bound equatorially, as is the case for codeine and morphine.
mesh_terms: D000328:Adult; D003061:Codeine / Q000009:adverse effects*; D004342:Drug Hypersensitivity; D005260:Female; D006801:Humans; D006968:Hypersensitivity, Delayed / Q000139:chemically induced; D008297:Male; D008875:Middle Aged; D008968:Molecular Conformation; D009020:Morphine / Q000009:adverse effects*; D010616:Phenanthrenes / Q000009:adverse effects*; D012008:Recurrence; D012541:Scarlet Fever / Q000139:chemically induced*
chemical_list: D010616:Phenanthrenes; D009020:Morphine; D003061:Codeine