Experimental observations on the pathology of lupus : with notes on three cases of lupus or tuberculosis of the skin of the hand / by Frederic S. Eve.

  • Eve, Frederick Samuel, Sir, 1853-1916.
Date:
1888
Catalogue details

Licence: Public Domain Mark

Credit: Experimental observations on the pathology of lupus : with notes on three cases of lupus or tuberculosis of the skin of the hand / by Frederic S. Eve. 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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    Case 2. Lupus? of palm of hand.—This interesting specimen, was brought by Mr. Bryant to the College of Surgeons. It com- prised a nodule which he had removed from the hypothenar eminence of the palm of the right hand of a man aged 26. Four years previously a tumour appeared at this situation, and was excised eighteen months before the present operation. This growth was examined elsewhere, and stated to be a fibroma, and recurrent growth formed, and was believed, from its appearance and the general circumstances of the case, to be a melanotic sarcoma. The skin covering it was of a faint black tint, raised, and on section a firm material was found to occupy the derma and subcutaneous tissue. Microscopic sections exhibited a nearly uniform mass of reticulated tissue covered by a layer of slightly thickened epithelium. In parts the remains of giant-cells, which had not become com- pletely incorporated with the reticulum, and areas where the reticulum was composed of the broad homogeneous bands so characteristic of tubercle, were observed. But for the most part it was indistinctly fibrillar, forming close meshes, enclosing small nuclei (reticular tubercle). Case 3. Papillary tuberculous formation on dorsum of hand.— This specimen was presented to the College Museum in 1875 by the late Mr. Gray. At that time it was examined by one of my pre- decessors, and on account of the overgrowth of epithelium the disease was thought to be epithelioma. I subsequently described it in the catalogue (No. 4078) as follows :—“ A hand, on the back of which a patch of skin near the bases of the second and third fingers is thickened and covered with scaly crusts and papillae. There is no thickening around the patch, but the skin was livid in the recent state. The third finger is represented by a stump, and at its extremity are several separate masses of low papillae.” No history is obtainable; but amputation of the ring finger was pro- bably performed for the same disease as that on the back of the hand. Section of the growth, recently made, showed under the microscope many tubercular areas, containing one or several giant- cells (see Plate XVIII, fig. 3). These occupied the papillary layer and corium. The cuticle was much thickened, forming several layers of cornified epithelium. The interpapillary processes of epithelium were extensively prolonged downwards. The rete Malpigliii was infiltrated with groups of leucocytes; and at oue point a giant- cell, surrounded by its zone of leucocytes, was completely enclosed