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October 1989

Mucocutaneous Lymph Node Syndrome: Is There a Relationship to Mercury Exposure?-Reply

Author Affiliations

Departments of Pediatrics and Dermatology Case Western Reserve University School of Medicine at Cleveland Metropolitan General Hospital 3395 Scranton Rd Cleveland, OH 44109

Am J Dis Child. 1989;143(10):1134. doi:10.1001/archpedi.1989.02150220022008

In Reply.—We appreciate the thoughtful comments of Drs Aschner and Aschner regarding the possible relationship of mercury exposure and the development of Kawasaki disease. As they note, a number of less obvious or frankly occult exposures to mercury exist, including that resulting from the use of certain diaper rinses. The patient described by us,1 however, wore disposable diapers, almost exclusively of the Ultrapampers variety. To our knowledge, mercury is not used in the manufacture of these products, thus obviating diapers as a source of potential exposure.

Acrodynia is appropriately included in the differential diagnosis of the cutaneous and systemic manifestations of Kawasaki disease. While Kawasaki disease and acrodynia share certain similarities of presentation, these processes may be distinguished by their unique clinical manifestations.2,3 Kawasaki disease has a sudden onset and a self-limited course, with the majority of overt clinical findings resolving within 1 month. In contrast, acrodynia manifests an

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