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Maria Theresa Hojyo-Tomoka, MD; Richard R. Marples, BM, MSc, MRCPath; Albert M. Kligman, MD, PhD

Arch Dermatol. 1973;107(5):723-727.

Abstract
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.

Author Affiliations
Philadelphia

From the Department of Dermatology, University of Pennsylvania School of Medicine, Philadelphia. Dr. Marples is now at the Central Public Health Laboratory, London.

Footnotes
Submitted for publication Oct 6, 1972.

Reprint requests to Department of Dermatology, Hospital of the University of Pennsylvania, Duhring Laboratories, Philadelphia 19104 (Dr. Kligman).

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