To the Editor.—
Patients with generalized skin disease may have abnormal response to infection.
Report of a Case.—
About two months before admission, a generalized desquamative skin disease that was diagnosed as generalized pyoderma with "id reaction" developed in a previously well and working 63-year-old boatman. He was given iodochlorhydroxyquin (vioform-hydrocortisone 1%) cream over his entire body for two weeks with no improvement. On the 17th hospital day, his temperature was 32.7 °C. He went into a coma on the 19th hospital day because of septicemia from the skin. Blood cultures grew Pseudomonas, and his blood pressure dropped to 70/60 mm Hg. Gentamicin and penicillin G sodium were administered and a warming blanket was used to maintain his temperature at 36 °C.He appeared to have abdominal pain that was aggravated by palpation. The amylase level was 319 Somogyi units/dl (normal, 30 to 200 Somogyi units/dl). Nasogastric suction was started.
Cucinell SA. Hypothermia and Generalized Skin Disease. Arch Dermatol. 1978;114(8):1244-1245. doi:10.1001/archderm.1978.01640200092043