Fatal oxprenolol poisoning.

Abstract

Deep-tissue factors-Provided the turgor of the deep tissues is sufficiently low, swelling of the epidermis will lead to wrinkling.Turgor is high when the sympathetic tone is low and the vessels are dilated.Thus in sympathec- tomised hands, which are typically warm, dry, and swollen, the tissue turgor is too great to allow the swelling of the epidermis to lead to wrinkling.Wrinkling will also fail to occur when sufficient oedema is present.We suggest that the phenomenon of finger wrinkling may be of value in the diagnosis and assessment of patients in whom autonomic neuropathy is suspected.The test is easy to apply and, unlike the Valsalva manoeuvre or loss of sinus arrhythmia, reflects peripheral rather than cardiac sympathetic denervation.We thank Mr D A Bailey for allowing us to study his patients.