Scleroderma and myositis / by J.A. Nixon.

  • Nixon, J. A.
Date:
[1907]
Catalogue details

Licence: In copyright

Credit: Scleroderma and myositis / by J.A. Nixon. 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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    suggested points of similarity may be quite wrongly inter- preted, still there remain some features in common which bespeak the same pathological processes underlying them. Case 1.—A healthy girl, aged 13 years, first came under the care of Dr. H. Waldo 18 months ago on account of a patch of painful, thickened, stiff, glossy skin on the right shoulder and arm, a narrow band extending from the posterior aspect of the acromion over the deltoid and down the outer and posterior part of the arm to a point a few inches below the elbow. It did not at first occupy so large an area as this but spread rapidly in the first week or so, then became stationary, and finally began to disappear, especially behind the shoulder where now the skin is practically normal; the white waxy appearance showed itself almost at once. Three months ago she developed a similar smaller patch about two inches long and one inch wide, oval in shape, on the left thigh just over the apex of Scarpa’s triangle, and now she is developing some indefinite thickening of the skin on the inside of the left knee just above the condyle of the femur. Also within a month or two of first attending the right hand was noticed to be smaller than the left, while the middle finger, although freely moveable as regards the joint, was incapable of being completely extended unless the wrist was flexed. The muscles of the forearm were not noticeably wasted nor lacking in power ; flexion and extension of the fingers were perfectly normal up to a point where the tendon of the flexor sublimis digitorum to the middle finger seemed to be stretched to its utmost and the finger could be no further extended, the flexion only being apparent at the metacarpo-phalangeal joint. This is the condition at present : there are no involve- ment of tendon-sheath or fascia as in Dupuytren’s contrac- tion and no true primary muscular atrophy, all electrical re- actions are normal, and it is neither a spastic contraction of the flexor muscle nor due to defective power in the extensor. This seems to be an essential shortening of muscle and tendon. The girl herself was not aware of any abnormality in this hand. There was no acute onset, no rheumatism, no pain, no tenderness, anaesthesia, or any symptom to attract the patient’s attention. Case 2—The patient was a single woman, aged 40 years, in domestic service. She showed changes in the skin of her -left arm and hand which dated either from birth or very early infancy. She had true sclerodactylia, the thumb and
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