Sarcoid tumors of the skin with report of a case of the Boeck type / by George Henry Fox and Udo J. Wile.

  • Fox, George Henry, 1846-1937.
Date:
1911
Catalogue details

Licence: In copyright

Credit: Sarcoid tumors of the skin with report of a case of the Boeck type / by George Henry Fox and Udo J. Wile. 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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    form differs from the Boeck type in presenting an even closer re- semblance to tuberculosis. The nodules are composed of epi- thelioid cells and lymphocytes, with numerous giant cells; the changes are less circumscribed and distinctly more infiltrating than in the Boeck form; but despite these differences the processes in the main seem very similar. A third group, suggested by Darier, includes cases resembling very closely the erythema induratum of Bazin and to which he has given the name, “sarcoides noueuses et nodulaires des membres.” The cases in this group are more numerous than in the other two; they occur principally in adult women, are chronic in course, and present, as a rule, hazel-nut-sized, reddish or purplish tumors, and in- filtrations on the arms and legs, the extensor surfaces being a special site of predilection. Such cases have been described as sarcoid by Pelagatti,12 Thibierge and Bord13 and by Darier himself. Many other authors have also described such cases, but have classed them as atypical examples of Bazin’s disease. Remembering that true Bazin’s disease may occur on the arms, body or even on the face, it is hard to separate this group of sarcoids from erythema induratum. Indeed this group further differentiates itself from the other sarcoids by occasional ulceration, and by the almost constant positive tubercu- lin reaction; furthermore, in isolated instances, Ravaut and Thi- bierge, 14 Carle,15 and Colcott Fox,18 were able to demonstrate tuber- culosis in inoculated animals, and Philippson17 succeeded in demon- strating tubercle bacilli in one case. Darier’s fourth type of sarcoid tumors embraces the cases of Spiegler and Fendt with round cells and non-tuberculous structure, which might be regarded as lymphogranulomata. In this group the lesions occur as purplish-red tumors lying deep in the cutis, chronic in course, exhibiting no tendency to ulceration and affected usually by arsenical medication. They have, except for a single fatal case reported by Spiegler, the same good prognosis as the Boeck and Dar- ier form. Histologically, they show aggregations of round cells more or less circumscribed, at times enclosed in a capsule of connective tis- sue. Giant cells and epithelioid cells occur in but small numbers. It is highly probable that many if not all of the so-called cured cases of sarcomatosis cutis belong to this group, which is readily dis- tinguished from true sarcomatosis cutis by the extreme malignancy of the latter and its tendency to invade the inner organs. That combination pictures of these several groups may occur is a point insisted upon by Darier. The following case, for example,