Superhydration of the horny layer by water-soaked cotton felt pads applied under continuous occlusion for seven days produced a vesiculopustular rash in 26 of 32 trials. This did not happen when occlusion was secured by impermeable plastic film alone. Although with superhydration various gram-negative bacilli became established, there was a compelling correlation with high surface levels of Pseudomonas. The severity of the rash was proportionate to the quantity of Pseudomonas, the density generally exceeding 0.5 x 106/sq cm.
Organisms were not found within the skin. The histopathologic findings were typical of a toxic reaction: epidermal necrosis, hemorrhage, and massive infiltration by neutrophils.
Hojyo-Tomoka MT, Marples RR, Kligman AM. Pseudomonas Infection in Superhydrated Skin. Arch Dermatol. 1973;107(5):723–727. doi:10.1001/archderm.1973.01620200041010
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