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April 7, 1945


JAMA. 1945;127(14):908-911. doi:10.1001/jama.1945.02860140026006

The clinical pictures of epidermal sensitization and dermal sensitization and the mechanisms of their production are well known to students of these problems. In their pure forms they constitute separate entities.

When the epidermis alone is sensitized it has generally been brought into this state of sensitization by previous contact of its surface with some external agent capable of producing sensitization. Such an agent may have been either a primary cutaneous irritant or a cutaneous sensitizer. The resulting clinical picture is known by the old name dermatitis venenata or the newer term contact dermatitis. It might well be called "epiderma-titis" because this term accurately describes the location of the shock tissue, which is the epidermis.

When the dermis alone is sensitized, the offending substance, the allergen, has generally reached it from within the body by way of the blood vessels or lymphatics. The allergen will generally have entered the body