Sir.—Twenty years have elapsed since Dr Warkany1 summarized the relationship between mercury poisoning and acrodynia in his elegant review "Acrodynia: Postmortem of a Disease." The current report serves as a reminder of the continued presence of the disorder and illustrates the inadequacy of a screening test (Reinsch's test) for the detection of mercury poisoning.
Patient Report.—A 30-month-old girl had a two-month history of progressive irritability and pruritus. Marked lethargy and hypertension (blood pressure, 134/102 mm Hg) were noted, and she was hospitalized for further evaluation. On admission, her weight was 10.2 kg; height, 86 cm; pulse rate, 140 beats per minute; and blood pressure, 144/92 mm Hg. The child was lethargic and hypotonic. There were multiple excoriations of the buttocks and thighs, and her fingers were erythematous and swollen.
Results of the following initial laboratory tests were normal: hemogram, urinalysis, serum electrolytes, glucose, blood urea nitrogen, and