A handbook on the diagnosis of skin diseases / by Robert Liveing.

Date:
1878
Catalogue details

Licence: Public Domain Mark

Credit: A handbook on the diagnosis of skin diseases / by Robert Liveing. Source: Wellcome Collection.

Provider: This material has been provided by the Royal College of Physicians of Edinburgh. The original may be consulted at the Royal College of Physicians of Edinburgh.

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    parts of the body it is often also present on the face. (5) It appears first in the form of tubercles, which have a tendency to ulcerate, and invariably leave indelible scars. (6) The extremely chronic nature of the disease, often lasting for many years, is a characteristic feature. Differential diagnosis.—There can be no doubt that the diagnosis between lupus and certain forms of syphilis is sometimes very difficult; indeed some writers still acknow- ledge a syphilitic lupus, but this generally means a syphilitic eruption closely resembling lupus. There is a gi'eat plausi- bility, however, in the hypothesis that lupus may attack a child who has inherited a syphilitic taint, and be conse- quently modified in its course, while it still retains the essential characters of a true lupus. Lupus that attacks the nose and leads to a considerable destruction of tissue often bears a close resemblance to syphilis. The same remark is true of the serpiginous form that attacks the extremities. The vei-y slow development and p)i-ogress of the disease, as compared with syphilis, is a most important point of dis- tinction. Again, in a doubtful case the complete failure of antisyphilitic remedies may sometimes be a valuable indica- tion that we have to deal with a case of lupus and not syphilis. The appearance of a lupus ulcer differs from that of a syphilitic one; the border is often irregular, and not sc sharply cut, the ulcer is not as deep, and bleeds more easily and freely, especially at the margin. The presence of a flat isolated lupus nodule in the neighboui'hood of an ulcer or in cases of the serpiginous form will be a valuable aid to diagnosis. Lastly, we may find a history, or some general sjTuptoms of constitutional syphilis, to guide us in arriving at a right conclusion in any given case. The diagnosis between lupus and epithelioma is much less difficult; for lupus, though it may continue or reappear until middle life, almost always/rsi shows itself at an early ao-e, and leaves marks in the sldn that cannot be overlooked; this is, of course, not the case with epithelioma, which is