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January 1949


Author Affiliations


From the Dermatologic Department, Pittsburgh Children's Hospital, Pittsburgh.

Arch Derm Syphilol. 1949;59(1):55-67. doi:10.1001/archderm.1949.01520260059009

During the past several years I have observed a chronic, benign and mildly inflammatory dermatosis which, because of its occurrence on bilaterally symmetric regions and its resistance to therapeutic measures, seems to merit description. The condition is an exogenic infection with hemolytic Staphylococcus aureus distributed by the fingers to bilaterally symmetric areas of the skin, where seemingly a bacterial allergic state and chronic circumscribed lesions develop. This supposed focal cutaneous allergy is regarded as a constitutional dermatoneurotrophic reflex, similar in mechanism to that in neurodermatitis and atopic dermatitis, inducing regional lowered resistance and a consequent delayed response to therapy.

This dermatosis was described by Adamson1 in 1908 as "a form of chronic superficial dermatitis in circumscribed patches with symmetrical distribution occurring in children"; he referred to the circumscribed patchy character of the eruption, the dry adherent crusting and scanty exudate, its probable pyococcic origin and its resistance to treatment.

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