Acute pemphigus : a contribution to the aetiology of the acute bullous eruptions / by George Pernet and William Bulloch.

  • Pernet, George.
Date:
[1896?]
Catalogue details

Licence: Public Domain Mark

Credit: Acute pemphigus : a contribution to the aetiology of the acute bullous eruptions / by George Pernet and William Bulloch. 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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    June 21st the patient pricked his left middle finger with a bone ; this wound also freely suppurated, the epidermis becoming detached, without the preceding formation of a bulla. At 7 p.m., on June 21st, about twenty rounded bullaa appeared on the inner parts of the thighs. This was followed by headache and pain during the night, and in the morning the patient vomited. On the 22nd and 23rd there were pain, headache, and shivering; and the sweating of the feet, usually abundant, was suppressed. On the morning of the 23rd the eruption became general, the bulla; on the thighs rupturing, with copious and fetid discharge. The Eruption.—He was admitted to the hospital on June 24th: eruption on inner parts of the thighs and on the right index-finger. Sleeplessness and vomit- ing. Bullae on the tongue, and also one on the soft palate. No enlarged glands. On the 28th the eruption had increased on the inner parts of the thighs, on the back and scalp. The bullae were large, without areola. Subsiding bullae on the tongue, the uvula and gums. The patient was better on June 30th, but on July 1st a fresh crop of bullae appeared. Confluent eruption : back, scalp, inner parts of thighs. July 5th.—A general erythematous eruption was noticed. By the 15th of the same month the patient was well. The discoloration of the skin following the bullae lasted fifteen months before they completely disappeared. Treatment.—General: One Pilule de Lutz is mentioned as having been given (? Opiat de Lutz : sulphur and honey). Local: Lycopodium powder and tannin. Case V.5—Francois B., a journeyman tripe-butcher, set. 17, under Horand, at the Antiquaille Hospital, Lyons (1872). History.—The patient has never had any venereal disease. He is a teetotaller. Nothing in the family history. He cannot assign any cause to his present illness. Lately he has worked harder than usual, and suffered slightly from diarrhoea. No malaise on the day preceding the eruption, which began on the morning of August 21st, when on waking he noticed small bullae on the fingers and toes. Some of these were ruptured when the patient washed himself, leaving superficial ulcerations. He went to work as usual. During the day fresh bullae appeared on the forehead, and during the night the eruption attacked the forearms. The Eruption and Course of Illness.—Admitted to the hospital on August 22nd. The eruption was discrete. Bullae, the largest not exceeding a small pea in size, on forehead, lips, forearms, fingers and toes. The patient was slightly feverish, and there was some watering of the eyes. During the night the eruption became general, and on the morning of August 23rd, bullae were distributed over the whole of the body. They ranged from a pin’s- head to an almond in size. Their contents were serous and pale yellow; some were umbilicated, others presented an areola. Between the toes and fingers, where the bullae had broken down, there were superficial greyish ulcerations, and the discharge from them was fetid and sanious. On the back and abdomen • there were erythematous patches : first stage of the eruption. Conjunctivae injected. Pulse, 64. Temperature, a.m., 38°; p.m., 37-8°. When seen on the 24th the bullae had considerably increased in size, especially 5 Horand, “ Note pour servir a l’histoire du Pemphigus aigu febrile,” Ann. de Derm, et de Syph., Vol. IV., 1872-73, p. 402.