Three case of xeroderma pigmentosum (Kaposi) or atrophoderma pigmentosum / by H. Radcliffe Crocker.

  • Crocker, H. Radcliffe (Henry Radcliffe), 1845-1909.
Date:
[1884]
Catalogue details

Licence: Public Domain Mark

Credit: Three case of xeroderma pigmentosum (Kaposi) or atrophoderma pigmentosum / by H. Radcliffe Crocker. Source: Wellcome Collection.

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    the skin small verrucose projections can be felt situated upon the pigment spots. These warts are in most cases the starting-points of the tumours. Here I would call attention to a point not noticed before, namely, the preva¬ lence of the ulcers and tumours upon the right side of the face. Out of twelve instances in which the side where these lesions began is mentioned, in nine it was upon the right and in only three upon the left side, and when both sides were involved they usually predominated upon the right. Clinically, the tumours may be described as verrucose and fungating, but pathologically, all observers except Taylor, of New York, have described them as epitheliomas, with the epidermic glands abundant in some but absent in others. That they are not always or at all times epitheliomas the present case demonstrates, and Taylor’s was not improbably like mine. It is, however, quite possible that if these tumours were left to irritate and be irritated that epithelioma might supervene, for the boun¬ dary dividing papilloma from epithelioma is often a very narrow one. Leloir and Yidal thought that the epithe¬ liomas develop in other structures besides the warts, as they found nodules of epithelioma in the middle of the corium, which they thought originated in the glands of the skin. It must be borne in mind, however, that on the Continent they use the term epithelioma in a somewhat wider sense than we do. With regard to the production of the ulcers I believe them to be due to infective pus. I have seen some of them evidently produced by the dis¬ charge from the eye, and in such ill-nourished tissues they are easily excited and kept up. The fact that in these cases they followed in the younger children so soon after their appearance in the elder suggests a similar explanation. If untreated they tend to fungate and perhaps become the site of an epithelioma, while some have described them as becoming rodent ulcers. The appearance of the tumours marks the beginning of the end. Glandular implication and general infection are