Psorospermosis follicularis cutis : a clinical lecture, delivered at the New York Post-Graduate Medical School and Hospital, October 8, 1890 / by L. Duncan Bulkley.

  • Bulkley, Lucius Duncan, 1845-1928.
Date:
1890
Catalogue details

Licence: Public Domain Mark

Credit: Psorospermosis follicularis cutis : a clinical lecture, delivered at the New York Post-Graduate Medical School and Hospital, October 8, 1890 / by L. Duncan Bulkley. 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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    tinctly hard, though greasy ; they are much the same on the cheeks, though here, as on other exposed parts, they are kept worn down by washing and friction. On the chest you see the disease most perfectly developed, and here, and on the abdomen, which is largely covered, the separate, hard, brown papules are more elevated, rougher, and of a darker color. On the back they are less thickly distributed, and on the forearms they are more closely set, forming patches. The groins and upper part of the thighs also exhibit thickly-devel- oped masses of them, but nowhere do we find them^ so large or prominent as have been described in one or two similar cases; nor do we find a very distinct, foetid odor which has been spoken of in other cases, although it is faintly marked here, and the patient says that at times it is much more perceptible. The hands are rather peculiarly affected by the dis- ease ; on the backs there are single isolated papules, similar to those seen elsewhere, and also brownish, dirty patches, evidently made up of the papules, closely packed together. Notice also the nails, which are affected in a very remarkable manner. They are all greatly thickened, so as to be raised from their bed, and the thickening is in the centre, while the sides of some are atrophied, giving almost a claw-like appearance to them. All of them are, as you see, very fragile, both at the ends and sides, with furrows and fissures running longitudinally. Observe, now, more closely the character of these papules, especially on the chest and arms, which appear at first sight to be firmly attached, and to form an inte- gral part of the skin. They are quite easily raised with the point of a knife, without pain, and leave behind them a small depression, reddened, and somewhat re- sembling the surface left after picking out very small cups of favus; in some of them which I have thus dug out there is a little bleeding at the base. These small