According to the concept of bacterids, foci of infection in the tonsils, teeth, sinuses, or some other portion of the body discharge toxins or bacterial products into the circulation, producing culturally sterile pustules or vesicopustules on the hands and feet. The lesions usually appear first on the midportions of the palms and soles, from which they spread to cover all of the volar surfaces and often the lateral aspects of the hands and feet. Advanced cases are bilaterally symmetrical and entirely pustular, with distinctive histologic findings. Exacerbations and remissions are frequent, but local therapy affords no relief. Eradication of the foci of infection, however, will effect a prompt cure. The patients are generally middle-aged adults, and the disease is commoner in women than in men.
All dermatologists do not accept this theory. It seems desirable, therefore, to record well-studied cases whose manifestations support this concept and
BUTTERWORTH T, GERMAN JE. Prophylactic Management of Recurrent Seasonal Bacterid: Report of a Case. AMA Arch Derm. 1959;79(3):325–327. doi:10.1001/archderm.1959.01560150067009
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