A case of dermatitis herpetiformis (bullosa) / by Louis A. Duhring.

  • Duhring, Louis A., 1845-1913.
Date:
1884
Catalogue details

Licence: Public Domain Mark

Credit: A case of dermatitis herpetiformis (bullosa) / by Louis A. Duhring. Source: Wellcome Collection.

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    T swelling, heat, and violent itching; the following day eruption manifested itself on the arms and around the neck, and later on the trunk. Several household remedies were applied, hut the disease spread until at the end of a week he was well covered with a mixed eruption consisting of papules, vesicles, and blebs, the latter predominating, and some being as large as a walnut. Upon bursting or being ruptured, the walls adhered to the skin and formed crusts. Successive crops of blebs continued to ap¬ pear until a fortnight ago—in all, during a period of eight months. He has lost flesh, as much, he thinks, as fifty pounds. A new outbreak of eruption is now manifesting itself. Present Condition.—The disease of the skin is almost uni¬ versal, involving the greater part of the general surface from the scalp to the soles of the feet. It is made up of variously sized and shaped vesicles, blebs, and pustules, in all stages of evolution. The vesicles predominate and vary in size from a pin-head to a pea, the majority being as large as small peas. They are notable for their irregularity of shape, being for the most part very irregular, and in many instances angular in outline. Some are raised to the height of a line, others are flat. They are distended and have a glistening, glazed look, and, as a rule, are not surrounded by any areola, rising abruptly from the surround¬ ing healthy skin. They are yellowish and contain serous con¬ tents, as in the case of the early stage of herpes zoster. The blebs, some raised, others inclining to flatten, are met with here and there on the neck, arms, thorax, abdomen, thighs, legs, feet, and hands. Some are as large as a pigeon’s egg. They are manifestly advanced stages of the vesicles, or at least often grow from these lesions. They are as a rule tensely dis¬ tended and have clear contents; some show cloudy contents and are flaccid. They do not rupture spontaneously. Their con¬ tents are alkaline. The pustules are present in like manner here and there, dis¬ tributed over the same regions. They are distinctly pustular, having whitish contents and more or less inflammatory areolae ; are small, raised, irregular in outline, though less so than in the case of the vesicles, and have a “puckered” or “drawn up”