| Popis: |
A good deal of attention has been devoted to skin diseases associated with plugging of the orifices of the sebaceous glands. Acnes, comedones, miia, some furuncles, folliculitides, lichen spinulosus, and keratosis pilaris are common examples of affections in which keratotic plugs in the openings of the piosebaceous apparatus have been recognized as an intimate part of the pathogenetic happenings. In contrast, but little attention has been accorded the role of plugging of the sweat gland orifices as an important part of the pathology of certain cutaneous diseases. Recent findings have made us feel that sweat glandobstruction deserved further consideration and more intensive study. The principal stimulus to the present studies was given by recent observations in the tropics (1, 2, 3). These observations confirmed those of S. Pollitzer (4) in that it could be shown that horny plugs in the openings of the sweat ducts occurred in prickly heat, and played a substantial part in the pathogenesis of this disease. It was further shown that the outfiowing of sweat was very much reduced or absent in and around the affected zones; and that this reduced or absent sweating could persist for some time after the acute clinical manifestations of ordinary miiaria were no longer in evidence. It was also demonstrated that the syndrome described by Allen and O'Brien (5) as tropical anidrotic asthenia and by Wolkin, Goodman and Kelley (6) as thermogenic anidrosis was associated with horny plugging of the openings of the sweat pores with an inhibition of outpouring of sweat; and with histologic and clinical cutaneous pictures (e.g. papulation, vesicle formation on exposure to elevated environmental temperatures) quite analagous to those found in the end stages of ordinary prickly heat. In the most recent studies from Guam (1, 2, 3) it was emphasized that prickly heat and tropical anidrotic asthenia might well be related to one and the same fundamental mechanism, namely occlusion of the sweat ducts, and consequent local cutaneous effects. It was inferred that when extensive areas were involved, the plugging of the pores, and the consequent failure to pour out (and evaporate) sensible perspiration when needed, could lead to profound disturbances of the heat-regulating mechanisms and systemic aberrations of great significance. |
