Two cases of Pagets disease of the nipple / by Louis A. Duhring.

  • Duhring, Louis A., 1845-1913.
Date:
[1883]
Catalogue details

Licence: Public Domain Mark

Credit: Two cases of Pagets disease of the nipple / by Louis A. Duhring. Source: Wellcome Collection.

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    [Extracted from the American Journal of the Medical Sciences for July, J 883. ] TWO CASES OF PAGET’S DISEASE OF THE NIPPLE.” By LOUIS A. DUHRING, M.D., PROFESSOR OF SKIN DISEASES IN THE UNIVERSITY OF PENNSYLVANIA. Two well-marked typical examples of this rare disease have within the year come under my observation. The notes are of interest, as showing the natural course of the process and the obstinacy of the lesions to treat¬ ment. I shall not at the present time enter upon discussion as to the nature of the disease, nor shall I refer to the views or the labours of other observers on the subject, beyond the mere statement that attention was first directed to the disease by Sir James Paget, in 1874, and that since cases have been reported by Munro, Lawson, Napier, Butlin, Henry Mor¬ ris, and others. It may also be stated, that particular study has been bestowed upon the disease by Thin, especially with regard to its nature, who has proposed to term it “ malignant papillary dermatitis.” The dis¬ ease has received but little notice outside of Great Britain. In this coun¬ try but few cases are on record. By the majority of practitioners it is regarded as u chronic eczema of the nipple,” and, indeed, most of the re¬ ported cases bear this heading, accompanied, perhaps, by an interrogation mark. That it is not an eczema, but that it is a peculiar disease with a malignant tendency, the following cases will show. Case I. Mrs. L—, aged 65, spare, and in average health, was sent to me by Dr. J. D. Strawbridge, of Danville, Pa., on March 23, 1882, for advice and treatment concerning a chronic, obstinate disease of the right nipple, areola, and breast, of an eczematous nature. The lady, who was intelligent, gave this account of the disease. It began ten years ago in the centre of the nipple in the form of a u roughness” with slight scaling. This continued for a period of six months, with at times slight oozing and crusting, without, however, Assuring or becoming excoriated. It was treated with “ caustics” for the next six months, at the end of which time the whole nipple was destroyed, as a result either of the disease or of treatment. From this date to the present time, a period of nine years, it has been gradually spreading, at first over the areola, then in the course of a few