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Am J Dis Child. 1915;X(6):436-444. doi:10.1001/archpedi.1915.04110060041006.
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I  Several years ago I was asked to see a little girl, 17 months old, suffering from a severe dermatitis of the diaper region. The skin of the buttocks, perineum, genitals, thighs, and lower abdomen was severely inflamed and numerous vesicles and blebs were scattered over this area. The infant appeared perfectly well otherwise. The mother stated that the diaper removed that morning had a very strong odor, "just like ammonia." She had saved the diaper in a closed receptacle. On unfolding the wet diaper, a very strong penetrating odor of ammonia was noticed. So strong was this gas that it irritated my eyes very disagreeably during the examination. It seemed clear to me that the skin lesions were induced by the ammonia in the urine, since ammonia is a powerful rubifacient and vesicant.This case served to interest me in the study of ammonia in the urine and the


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The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
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