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July 3, 1937


Author Affiliations

San Francisco. Professor of Public Health and Preventive Medicine, Stanford University School of Medicine.

JAMA. 1937;109(1):66. doi:10.1001/jama.1937.02780270068022

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To the Editor:—  In The Journal, May 1, is an editorial entitled "Causative Factors in Erythema Nodosum." The editorial is based chiefly on a recent article in the Archives of Internal Medicine by W. W. Spink, who reported a critical study of ten cases of erythema nodosum in which only one gave evidence of tuberculosis. The relationship to streptococcic infections was particularly stressed. His conclusion was that "erythema nodosum appears to be a nonspecific inflammatory reaction of the skin to a variety of bacterial, toxic and chemical agents."It would seem timely to draw attention to the fact that in the San Joaquin Valley in California there is endemic a relatively mild febrile disease which is characterized by a bad cold or bronchopneumonia, associated with erythema nodosum. The patients usually recover promptly and, apparently, without complications. The disease is often diagnosed as erythema nodosum and is popularly known in the

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