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They often have a positive Nikolsky sign, ie, where traction pressure causes epidermal shearing and erosion (Figure 1)

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Nevertheless, there is increasing evidence that exposure to environmental pollutants considered as endocrine disruptors contribute to this pathology’s development, including smoking, particulate matter, persistent organic pollutants, and heavy metals, including arsenic ( Arsenic naturally occurs in the Earth’s crust and is also a pollutant produced by diverse industrial activities such as mining, fracking, coal-fired power plants, arsenic-treated lumber, and arsenic-containing pesticides