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In this book, Simons clearly points out several commonly held misconceptions concerning dyshidrosiform eruptions. There is also a complete review of the problem in historical perspective.
The investigator concentrated on three major areas; a histological study of the "dyshidrosiform" eruptions and examination of the pH of vesicles, a study of the seasonal rhythms, and a critical review of the dermatophytid concept. He studied about 10,000 serial sections histologically and in all instances found some vesicles not associated with sweat ducts. Then using the litmus paper method, he determined whether or not hyperhidrosis was present. The results indicated that hyperhidrosis in no way correlates with dyshidrotic disease.
In addition, the pH of vesicle fluid was uniformly more alkaline than the pH of sweat from the same person.
Investigation into the seasonal rhythm revealed no correlation with temperature, atmospheric pressure, or humidity, but the revival (R) peaks did occur in spring and
Porter PS. Eczema of the Hands. Arch Dermatol. 1967;95(4):424-425. doi:10.1001/archderm.1967.01600340084021