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

Sir.—We were interested in the article by Krowchuk et al¹ in the November 1988 issue of AJDC about the occurrence of exanthem limited to the diaper area in a 21-month-old male child diagnosed as having Kawasaki disease. We were disappointed that the authors failed to note the type of diapers used by this child. This case brings to mind a 1981 report² of acrodynia, or "pink disease," in thousands of infants in Buenos Aires, Argentina, who were poisoned by mercury from commercially laundered diapers. The causative compound was phenylmercury, which was added to the laundering process because it is such an effective fungicide and reduces the odors produced during washing and storing. A causal relationship of Kawasaki disease and inorganic mercury poisoning was first suggested by Cheek,³ following observations that acrodynia has many symptoms similar to mucocutaneous lymph node syndrome (MLNS).

Acrodynia, or "pink disease," was