Erythema elevatum diutinum / by H. Radcliffe Crocker and Campbell Williams.

  • Crocker, H. Radcliffe (Henry Radcliffe), 1845-1909.
Date:
[1894]
Catalogue details

Licence: Public Domain Mark

Credit: Erythema elevatum diutinum / by H. Radcliffe Crocker and Campbell Williams. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    arsenic internally had no effect. The distribution of the eruption in November was as follows :— Right-hand Dorsum.—The skin over the joint between the first two phalanges of the index finger was thickened and purplish. Passing over the radial side of this thickened skin was the raised defined margin of the projecting portion of eruption from the palm ; the radial side of this finger more distally was also purplish and a little thickened. On the ring finger, there were two large nodules on the back of the terminal phalangeal joint; they were oval in shape, one-third of an inch in length, and their distal ends converged ; in appearance they reminded one strongly of gouty tophi. There were three smaller nodules on the ulnar side of this joint; all these nodules were thickenings of the skin, and moved with it; they were purplish in colour. The ends of the phalanges forming this joint felt distinctly thickened. The little finger was free except for a patch on the back of the metacarpal joint, which was nearly one inch square, and had a defined edge with a purple tint passing into yellow. It turned round to join the eruption on the palm. There was another patch by 21- inches on the inner side of the wrist, extending a little above and over the styloid process of the ulna, and forwards over the inner fourth of the wrist. Just below the styloid process towards the palm, the tissues were much thickened, forming a ridgy nodular condition similar to the scar thickening of a burn. There was a second patch over the middle two thirds of the anterior aspect of the wrist. On the palmar aspect the centre was free, and also a tract of skin passing to the ulnar surface of the hand ; but even here the skin was a little thickened and of yellowish tint. The most deeply congested part was the ball of the thumb and the fore part of the metacarpus; there was a defined curved edge, concave to the palm, and raised edges along the sides of the fingers, abruptly separating the eruption from the healthy skin on the posterior aspect. This defined edge was much thickened in several places, especially on the radial border of the thumb, where, in fact, it was made up of a series of irregular nodules. The eruption passed back over the knuckle of the thumb to within a quarter of an inch of the raised edge of the eruption, which projected back from the palm to line the sides of the interval between the thumb and first finger. On the left hand, the eruption had a similar distribution. On the dorsum, the metacarpus and the ring-