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Drs Sequeiros and Sack point out that a nongenetic intrauterine insult is the most likely cause of our findings. They also note that a number of laboratory studies suggest the possibility of intrauterine infection. Although we agree with Drs Sequeiros and Sack that an intrauterine infection may have produced the cutaneous and mucosal findings, cultures and serologic studies for specific agents were negative. Moreover, we were not able to find any reports in the literature of intrauterine infection associated with extensive supple reticulated scarring.Drs Sequeiros and Sack refer to the mucocutaneous findings as "linear skin atrophy," and then point out that "in all three patients, there seemed to be areas of thickening of the dermis or an increase in collagen density." In fact, the biopsy specimens in all three cases were remarkably normal, except for a paucity of adnexal structures. The presence of increased collagen is
Cohen BA. Infection and Prematurity as the Cause of Linear Skin Atrophy, Alopecia, Anonychia, and Tongue Lesions?-Reply. Arch Dermatol. 1985;121(11):1380. doi:10.1001/archderm.1985.01660110027004