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

Mucocutaneous Lymph Node Syndrome: Is There a Relationship to Mercury Exposure?-Reply Abstract 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 References 1. Krowchuk DP, Bass J, Elgart GW. Kawasaki disease with an exanthem limited to the diaper area . AJDC . 1988;142:1136-1137. 2. Kawasaki T. Comment on mucocutaneous lymph node syndrome: could it be a heavy metal poisoning? Pediatrics . 1975;56:336-337. 3. Dinehart SM, Dillard R, Raimer SS, Diven S, Cobos R, Pupo R. Cutaneous manifestations of acrodynia (pink disease) . Arch Dermatol . 1988; 124:107-109.Crossref 4. Urbach AH, McGregor RS, Malatack JJ, Gartner JC, Zitelli BJ. Kawasaki disease and perineal rash . AJDC . 1988;142:1174-1176. 5. Friter BS, Lucky AW. The perineal eruption of Kawasaki syndrome . Arch Dermatol . 1988; 124:1805-1810.Crossref 6. Rauch AM. Kawasaki syndrome: review of new epidemiologic and laboratory developments . Pediatr Infect Dis J . 1987;6:1016-1021.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png American Journal of Diseases of Children American Medical Association

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

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

Abstract

Abstract 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...
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References (7)

Publisher
American Medical Association
Copyright
Copyright © 1989 American Medical Association. All Rights Reserved.
ISSN
0002-922X
DOI
10.1001/archpedi.1989.02150220022008
Publisher site
See Article on Publisher Site

Abstract

Abstract 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 References 1. Krowchuk DP, Bass J, Elgart GW. Kawasaki disease with an exanthem limited to the diaper area . AJDC . 1988;142:1136-1137. 2. Kawasaki T. Comment on mucocutaneous lymph node syndrome: could it be a heavy metal poisoning? Pediatrics . 1975;56:336-337. 3. Dinehart SM, Dillard R, Raimer SS, Diven S, Cobos R, Pupo R. Cutaneous manifestations of acrodynia (pink disease) . Arch Dermatol . 1988; 124:107-109.Crossref 4. Urbach AH, McGregor RS, Malatack JJ, Gartner JC, Zitelli BJ. Kawasaki disease and perineal rash . AJDC . 1988;142:1174-1176. 5. Friter BS, Lucky AW. The perineal eruption of Kawasaki syndrome . Arch Dermatol . 1988; 124:1805-1810.Crossref 6. Rauch AM. Kawasaki syndrome: review of new epidemiologic and laboratory developments . Pediatr Infect Dis J . 1987;6:1016-1021.Crossref

Journal

American Journal of Diseases of ChildrenAmerican Medical Association

Published: Oct 1, 1989

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