Psoriasis--verruca--epithelioma : a sequence / by James C. White.

  • White, James C. (James Clarke), 1833-1916.
Date:
[1885]
Catalogue details

Licence: Public Domain Mark

Credit: Psoriasis--verruca--epithelioma : a sequence / by James C. White. Source: Wellcome Collection.

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    class of his system contains the following subdivisions, which in their mutual relations are of especial interest in connection with the cases under our consideration, as shown in the accompanying table:— 7th Class.—Epidermidoses = Anomalies in the growth of the cuticle. A. Keratonoses = Anomalies of formation of the horny layer. Family II. Parakeratoses = Quantitative anomalies in the pro¬ cess of cornification. Psoriasis. C. Akanthoses = Anomalies of the prickle layer of the epidermis. Family I. Hyperkanthoses = Simple akanthoma. Verruca — Warty akanthoma. Family II. Parakanthoses = Alveolar akanthoma. Epithelioma. (With cornification of the cells of the new growth.) He recognizes the following anatomical changes as of constant occur- rence in psoriasis; an increased thickness of the horny layer ; certain changes in the stratum granulosum and stratum spinosum indicating more rapid transformation in their development than is natural, as shown by an increase of the nuclei in the deeper layers of* the prickle cells and a more abundant granulation in the uppermost, in those undergoing trans¬ formation into the true granular cells, together with a more rapid loss of their spines, and a thicker superposition and change in form of the cells of the cylindrical layer; and, finally, an overfilling of the papillary capil¬ laries. He regards the disease, therefore, not as an inflammatory affection, but as an anomaly of the process of cornification of the epidermis, and im¬ perfect transformation, that is, of its cells, so that those of the horny layer do not adhere closely, and form dry and scaly elevations, while the younger, deeper layers are also less adherent, so that the cylindrical layer is easily laid bare above the hyperiemic tips of the papillae, which bleed readily on such denudation. In verrucce we have a quantitative change in the formation of the stratum spinosum, an excessive formation of the prickle cells, extending in some forms far downwards into the corium between the papillae, thus simulating a marked prolongation or hypertrophy of these bodies. The down-growth of the epidermal cells is always continuous, however, and nipple-shaped in its encroachments upon the cutis. The cornified cells of the upper layers are magnified in quantity in the same proportion. Whenever this uniformity or continuity of epithelial hypertrophy or new growth is interrupted in its invasion of the tissues of the corium, and the epidermal cells are found seemingly developed in separate foci below the general line of the rete, we have another condition to which we apply the title epithelioma or carcinoma. In it the prickle cells are arranged in no orderly manner, but permeate the tissues of the corium in all direc¬ tions it may be, or congregate in nests or alveoli, taking their origin either from the cells of the epidermis or from their continuations along the glandular structures of the cutis.