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Article
November 1977

Transient Acantholytic Dermatosis

Author Affiliations

San Francisco

Arch Dermatol. 1977;113(11):1611. doi:10.1001/archderm.1977.01640110131033
Abstract

To the Editor.—  We are concerned about the report of a so-called variant of transient acantholytic dermatosis (TAD) by Waisman et al.1 Their three patients all exhibit the clinical, histologic, and therapeutic picture of bullous impetigo (BI), but test data to exclude this more common entity, eg, skin lesion culture and Gram's stain, coagulase and phage typing, and injection of organisms into neonatal mice,2 were not presented.Clinically, the crusted, bullous lesions (some of which became purulent) with a + Nikolsky's sign, which originate periorificially, are typical of BI. Therapeutically, the partial response or nonresponse to penicillinase-sensitive or bacteriostatic antibiotics is consistent with BI. Incidentally, the observation of new bullae possibly precipitated by sunlight or suctiontrauma is interesting but may be coincident since BI prefers exposed surfaces too.Histologically, the appearance of acantholysis3 with negative immunofluorescence, and, particularly, a high cleavage plane

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