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June 1983


Author Affiliations


From the Department of Medicine, State University of New York, College of Medicine at New York City, Kings County Hospital and the Medical Research Department, Equitable Life Assurance Society of the United States.

Arch Dermatol. 1983;119(6):513-524. doi:10.1001/archderm.1983.01650300067018

ALTHOUGH i. noxious agents, the capacity of individual tissues to react is much more circumscribed. The pathologic changes manifested by tissues in disease states may be very similar despite varying causative factors.1 Therapy need not necessarily be directed specifically at the causative agent, but may effectively suppress functional and morphologic responses of the shock organ which, in effect, constitute the disease process. Nowhere, perhaps, is this more clearly evidenced than in the spectrum of disorders which respond so dramatically to compounds E and F of the adrenal cortex. Such diverse entities as rheumatoid arthritis, rheumatic fever, lupus erythematosus, periarteritis nodosa, and gout, have in common only that their clinical and pathologic manifestations are due largely to involvement of the connective tissues.

The adrenal cortex, vital though it is in mobilizing body reactions to stress, is. as stated by Albright,2 "anti-anabolic." The lesions of Cushing's disease are characterized by