On the relationship of some forms of integumentary atrophy / by Dyce Duckworth.

  • Dyce Duckworth
Date:
[1883]
Catalogue details

Licence: Public Domain Mark

Credit: On the relationship of some forms of integumentary atrophy / by Dyce Duckworth. Source: Wellcome Collection.

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    and the colouring matter of the hair. In the same case, the one tissue may be affected by itself, or both may he influenced together. The pathogeny of these conditions is now attributed, rightly or wrongly, to defective innervation. In my opinion, strong evidence in favour of this view is, in many instances, not far to seek. Passing next to more obvious atrophies, there are met with sharply defined patches of area in which the hair is lost and the integument distinctly wasted, so that it is depressed below, and less sensitive than, the surrounding parts, also thin and glossy. This is a disorder which has been the subject of much study and debate. For a long time this disease was supposed to be a form of ringworm, and a definite epiphyte was described and depicted as its cause. Of late years this view has been discarded, and the theory of defective innervation has been invoked to explain the phases of the derangement. Later still, this theory has been assailed, and certain bacteria have been described as the vicious agents, thus restoring the parasitic idea. For myself, I hesitate to accept the latter theory, believing it to be inconsistent with clinical observa¬ tion as applied to the whole phenomena of the disorder. I have elsewhere1 expressed my views at length as to the nature of area, and shall only add that this disease may occur in varying degrees of severity, being sometimes mild and temporary, and sometimes grave and permanent. It is not unimportant to note further that pigmentary atrophy is sometimes associated with it in the form of leucoderma, and that such change always accompanies the restoration of the parts, skin and hair, to health. From this condition I pass to consider the local atrophy ob¬ served in maculated and striated patches, and that resulting ulti¬ mately from scleroderma in some of its varieties. In these cases there is always to be noted a primary phase, of which vascular disturbance and new growth form part. It is a matter of common opinion that these lesions result from disordered innervation, and many facts support this view, especially those which indicate that the disease follows the line of distribution of certain nerves, and may be the seat of sensory disturbances. It is also interesting to note that pigmentary changes are sometimes associated with these conditions. I am aware that dermatologists place scleroderma and morphcea, which I believe to be only varieties of one malady, amongst hypertrophic affections, and in their earlier phases this may be justifiable. But in the evolution of many cases the atrophic stage is reached, and this, I think, must be held to warrant the inclusion of these disorders amongst local atrophies. The local changes described as “glossy skin” may fairly be mentioned in association with the nutritive perversions just men- 1 St Barth. Hosp. Reports, vol. viii., 1872, p. 144.
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