Trophoneurotic changes in bones and joints in leprosy / Francis Harbitz.

  • Harbitz, Francis Gottfred, 1867-
Date:
1910
Catalogue details

Licence: In copyright

Credit: Trophoneurotic changes in bones and joints in leprosy / Francis Harbitz. 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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    must be maintained that the trophoneurotic changes are associated with advanced leprous neuritis of the mixed nerves, and not with a definite form of the disease, or with particular lesions of the central nervous system, or certain nerves. In this connection, it must be remembered that similar concentric atrophy of the toes has been described as following nerve lesions of vari- ous kinds, such as gunshot wounds, causing destruction of peripheral nerves, in which case the atrophy was characterized by the toes being shorter and more pointed at the ends just as we see in characteristic leprous bone atrophy. Fig. 24.—Cast of right foot; lepra mutilans. We must also consider the cutaneous changes occurring in leprous fingers and toes. The skin becomes thin, atrophic, smooth and glisten- ing (“glossy skin”), with atrophy of epidermis, cutis and subcutaneous tissues and with disappearance of glands and loss of hair. It has been noted in our cases that the skin finally has become scar-like and inelastic. The nails also undergo changes as they cease to grow and fall off, or become corrugated, rough, and chipped, or greatly thickened and nodular. It may be generally known, as has been shown by Hansen and Looft,G that these cutaneous changes are due to leprous neuritis and are tropho- 6. Hansen and Looft: Die Lepra vom klinischen und pathologisch-anatom- ischen Standpunkte, Bibliotli. med. int., 1894, ii.