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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    their bases; the pustules, on the other hand, were always mark¬ edly inflammatory. On each occasion of the pustular form of eruption he “felt badly,” and was in poor general health. He. had had but three or four “pustular attacks,” the rest having all been vesicular and bullous. The disease, whatever the form of lesion, always manifested itself in attacks, which would an¬ nounce themselves at intervals of weeks or months, one scarcely subsiding before another would appear. He does not remember that any of the attacks were preceded by chills or fever. The seasons seemed to exert no influence on the course of the dis¬ ease. ne noticed that frequently the lesions inclined to come out in the form of groups or clusters, four or tive appearing within a radius of an inch or two, and often coalescing. The regions invaded have been the same as in the beginning—the face, neck, elbows, knees, sacral region, and buttocks being the favorite localities. The genitalia, hands, and feet have generally been free ; the palms and soles have always escaped. His condition when I saw him in January, 1879, was very similar to that recorded as existing when I first observed the case in 1874, and therefore need not be described in detail; so much did his condition resemble the former state, as regards the general character and distribution of the eruption, that it seemed as though the very same lesions were present. The pus¬ tules were the only lesions. They were of all sizes, most of them being as large as dimes and quarter-dollars; rounded or irregular in shape; crusted with yellowish-brown crusts; flat; here and there clustered or about coalescing; in all stages of development, and surrounded by highly inflamed, extended, bright-red areola. They, moreover, possessed the characteristic before noted of extending around the periphery and just beyond the line of the central crusting. The patient was ordered wine of iron, with three-minim doses of liquor potassii arsenitis thrice daily. With the view of observing the course of the lesions, local treatment was withheld. March 11,1879.—The case has been under constant obser¬ vation since the previous note, six weeks ago, during which time the disease has behaved much as it did on the first occasion I had of studying it. The lesions have pursued a rather slow