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David Paslin, MD; Michael E. Norman, MD

Arch Dermatol. 1977;113(6):801-805.

Abstract
• A 22-year-old white woman with Job's syndrome was found to have atopic dermatitis and impaired neutrophil chemotaxis in vitro. Major clinical features of Job's syndrome included large, "cold" and recurrent staphylococcal abscesses, and intermittent bacterial and yeast infections. Evidence for atopic disease included infantile eczema progressing to flexural dermatitis, a family history of atopy, positive immediate hypersensitivity skin tests, and hyperimmunoglobulinemia E. Defective erythema responses to histamine, methyl niacinate, and methacholine (Mecholyl) chloride may explain the lack of redness, heat, or pain signalling the development of abscesses (hence the term "cold"). Impaired chemotaxis was probably due to an intrinsic neutrophil defect since patient's serum generated normal amounts of chemotactic factors and did not contain an inhibitor of neutrophil chemotaxis. A delay in neutrophil exudation in vivo may explain the abscess formations and the atopic diathesis may explain the absence of clinical signs of inflammation that have been described in this and other patients with Job's syndrome.

(Arch Dermatol 113:801-805, 1977)

Author Affiliations
From the Departments of Dermatology and Pediatrics, University of Pennsylvania School of Medicine, Philadelphia. Dr Paslin is now with the University of California School of Medicine, San Francisco.

Footnotes
Accepted for publication May 11, 1976.

Reprints not available.

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