Acne atrophica or lupoid acne / by L. Duncan Bulkley.

  • Lucius Duncan Bulkley
Date:
[1882]
Catalogue details

Licence: Public Domain Mark

Credit: Acne atrophica or lupoid acne / by L. Duncan Bulkley. Source: Wellcome Collection.

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    /\^b springs from a single lesion. In the former, the lesions are circularly arranged without being in contact; while in the latter, the peripheral border forms a continuous line of less decided elevation. It is, moreover, much less slow in its course. In the unusual event of a papulo-tubercu- lar or tubercular lesion of late syphilis, following a centrifugal enlarge¬ ment, as in the earlier papular syphiloderm, and as is represented in the already-mentioned plate of the atlas of Kaposi (see also Plate xxxi.), there can be no doubt that the lesions depend upon the same trophic influence, and that their anatomical differences are such only as those indicated in the clinical terms papule and tubercle. The later lesion would be appropriately denominated syphiloderma tuberculatum circi- natum. ACNE ATROPHICA OR LUPOID ACNE. BY L. DUNCAN BULKLEY, A.M., M.D., Attending Physician for Skin and Venereal Diseases at the New York Hospital, Out-Patient Department, etc. fTHE eruption to which attention is here called is one which not infre- JL quently passes unrecognized, and one which has received very little mention in works upon diseases of the skin. Cases of it are, however, by no means rare, the following three striking examples being all observed in private practice within a period of about two years; while a number of others have presented themselves before and since. The importance of a correct diagnosis of this eruption can hardly be overestimated, as it is most commonly mistaken for one of the lesions of syphilis; it is also pecu¬ liarly rebellious to any but a rightly directed treatment. The character¬ istics of the eruption can be best judged from a brief report of the cases:— Case I.—Mr. Charles-, aged forty-five, a spare, rather nervous gentleman, stated that he had always enjoyed good health, with the ex¬ ception of what he designated bilious headaches. He had six healthy chil¬ dren, all living, and with no eruptions. He presented no physical signs of disease, and his bodily functions appeared to be perfectly performed; the bowels acted freely; there were no stomach symptoms, except that very rich food disagreed; the tongue was slightly coated and pale; the pulse 66; sleep good and refreshing. About ten years previous to his first visit, March 23, 1880, the erup¬ tion had first appeared upon the forehead, just below the margin of the scalp, and since that time he had never been free from some lesions, gen¬ erally about a dozen or so points existing at the same time upon some por¬ tion of the face and neck. The character of the eruption had remained the
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