Notes of a case of dermatitis herpetiformis during thirteen years / by Louis A. Duhring.

  • Duhring, Louis A., 1845-1913.
Date:
[1884]
Catalogue details

Licence: Public Domain Mark

Credit: Notes of a case of dermatitis herpetiformis during thirteen years / by Louis A. Duhring. Source: Wellcome Collection.

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    was the first occasion of the lesions being distinctly multiform. This attack lasted only a fortnight, vanishing quite suddenly, and leaving the skin in a better state than for months. This last form of eruption, however, soon recurred, lasting, as previ¬ ously, but a few weeks, and, as before, leaving him apparently quite well. He has had many attacks of this character, at in¬ tervals of a few months, up to the present time. The disease has thus continued its course, uninfluenced by the varied treat¬ ment to which he has been subjected. lie does not think that the seasons have at all influenced the natural course of the dis¬ ease. It was at this period (July, 1874) that the patient first pre¬ sented himself to me. lie showed the pustular phase of the disease, which had hut recently made its appearance. There were about a score of disseminated, split-pea and finger-nail sized, flat, mostly crusted with a yellowisli-brown, adherent, flat, ecthyma-form crust, here and there distinctly clustered pus¬ tules. They occupied the lumbar and sacral regions, the but¬ tocks, and the elbows and knees. They had appeared a fort¬ night previously, and had been and were still accompanied by itching. The more recent lesions I observed were surrounded with bright-red, highly inflammatory areolae, and were pecul¬ iar in that they inclined to crust in their center and to spread on the periphery, forming more Or less distinct, narrow rings of pustulation immediately beyond the line of the crust. This fea¬ ture was not constant, but existed in connection with a number of the lesions, and constituted a symptom which at once arrested my attention. The case was regarded as an unusual one, the form of dis¬ ease being entirely new to me, and this observation was so re¬ corded in connection with the notes. The lesions bore a close resemblance to cachectic ecthyma, but the localities attacked were those seldom invaded in this latter disease. The pustular variety of eczema, aggravated by some irritating application, also suggested itself, as did, moreover, impetigo contagiosa. The contents of several of the pustules, as well as the crusts, were at the same time submitted to microscopical examination with a view of determining if any parasite was present. The