Impetigo contagiosa : its clinical features / by Henry W. Stelwagon.

  • Henry Weightman Stelwagon
Date:
[1883]
Catalogue details

Licence: Public Domain Mark

Credit: Impetigo contagiosa : its clinical features / by Henry W. Stelwagon. Source: Wellcome Collection.

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    bilicated, and beginning to dry. One small vesicle had appeared on the con¬ junctiva of the left eye, causing slight hypersemia and a trifling sero-purulent discharge. The confluent patch and the older bullae were covered with a dry, yellowish and brownish-yellow, thin, granular, wafer-like crust, somewhat turned up at the edges only slightly adherent, and appearing as if imperfectly pasted on. Several new vesicles had appeared, but showed less tendency to enlarge. One or two had been rubbed, and seemed like superficial abrasions. Forty-eight hours later all the bullae had given place to simple crusted patches of the character already described. At the margin of the oldest patches the crust had begun to crumble off. Two days afterwards, the disease was fast disappearing ; the crust of the discrete patches, with few exceptions, had entirely fallen off, leaving erythematous spots. On some of the patches a few small fragments were still clinging. At the end of a few days nothing was seen of the disease except the erythematous spots showing the sile of the eruption ; these gradually faded. The disease had run its course in about two weeks. This case pictures the typical disease. At times the eruption is con¬ fined to the face, as occurred in fifteen of my cases. In others, in. addition to the face the scalp shows some patches, or the disease may begin on the scalp. In others, again, the hands and arms, and not infrequently the legs and feet, are affected. The mucous membranes of the eye and nose are sometimes the seat of vesicles. Beginning usu¬ ally on the face, it may extend to all parts; the trunk seems the least vulnerable. Ordinarily the eruption is seated upon the face and hands. On the extensor surface of-the fingers, near or around the nail, is a favorite locality for the eruption wherf attacking the hands. . Occurring here, it closely simulates a burn, and the lesion is, more¬ over, apt to be more persistent. The disease was occasionally ushered in by fever and malaise, which subsided as soon as the eruption appeared. The sub-maxillary glands were in a few instances observed to be enlarged. In most of the cases, however, constitutional symptoms were entirely absent, or so slight as to escape notice. The disease is usually unattended with any sub¬ jective symptoms. Occasionally the eruption is a little itchy in the beginning; but even this is an exception. The eruption, when oc¬ curring in children with a tendency to eczema, may, if improperly treated or irritated, develop into that disease. This occurred in three of my cases, in which the primary eruption was unquestionably con¬ tagious impetigo. The lesions are superficial, and begin as vesicles, rapidly becoming vesico-pustular, enlarge by extension at the periphery into bullse, varying in size from a split pea up to a dime or larger;
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