Selected monographs on dermatology / P.G. Unna [and others].

Date:
1893
Catalogue details

Licence: Public Domain Mark

Credit: Selected monographs on dermatology / P.G. Unna [and others]. Source: Wellcome Collection.

    590/636 (page 572)
    tary case was one of eczema seborrhceicum. A few cases of psoriasis confined to the trunk are recorded by McCall Anderson. This circumstance is valuable in differential dia- gnosis, especially in the case of syphilis. Volse and (or) plantse were attacked in 7 per cent. (65 times) of all cases (927), and in 8*9 per cent. (55 patients) of the 616 patients ; but in 78 cases (66 patients) where we ourselves noted the smallest efflorescence this localisa- tion was still more frequent, viz. 15 times (13 patients), or in 19*2 per cent, of cases and in i97 per cent, of patients. This is much more often than is commonly stated; of course syphilis was most carefully excluded. In one case only where the diagnosis of psoriasis seemed certain was the eruption confined to the palms and soles. On reference to the litera- ture of psoriasis only two cases are recorded (Angel and Neumann) where the eruption was thus limited for some years, and afterwards appeared in the usual regions. The volas and plantas were most frequently attacked where the eruption was very extensive or of the inveterate type. Sometimes, however, when it was slight or the first attack, these regions were involved. In two patients the palms and soles were attacked every time. The number of males pre- dominated—54 males, 11 females,—possibly because of their greater exposure to mechanical irritation. Thus, in one patient who always carried his stick in the left hand, that palm was more affected than the right. The soles and palms were attacked 31 times simultaneously, the palms alone 24, the soles alone 10 ; both palms or both soles were most frequently affected. The diagnosis is not so difficult as is usually stated. It differs from syphilis especially in desquamation beginning in the centre of the efflorescence, the abundant formation of scales, and the very slight infiltration. Its course is similar to psoriasis in other regions. Psoriasis of the nails occurred 8 times (7 patients) among 78 cases (66 patients), io-2 per cent, of cases and io*6 per cent, of patients. It was most frequently seen in extensive and old-standing (Ps. inveterata) psoriasis, and in the majo- rity of cases the hands and and feet were implicated ; the nail folds, palms, and soles likewise, but not invariably so.