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Walter B. Shelley, M.D., Ph.D.
JAMA. 1953;152(8):670-673. doi:10.1001/jama.1953.03690080014004.
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The physiological significance of the millions of sweat glands spread over the body surface is well known and appreciated, although there has been a general failure to recognize the significance of these tiny glands in the pathogenesis of skin disease. Studies in the last 10 years have indicated clearly that the sweat gland is either primarily or secondarily responsible for a wide variety of common dermatological disturbances. All of the disturbances result from a simple mechanical obstruction at the sweat duct opening; although the formation of sweat proceeds unimpeded, the free egress of this sweat onto the skin surface is prevented. In consequence, sweat is trapped and retained within the skin, leading to a remarkably varied clinical patterning. For many years, these clinical facets of sweat retention went unrecognized or were misdiagnosed. It is now possible to define more precisely and simply the clinical features and the pathogenesis of cutaneous


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