Notes of a case of dermatitis herpetiformis during thirteen years / by Louis A. Duhring.

  • Louis Adolphus Duhring
Date:
[1884]
Catalogue details

Licence: Public Domain Mark

Credit: Notes of a case of dermatitis herpetiformis during thirteen years / by Louis A. Duhring. Source: Wellcome Collection.

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    course, considering their highly inflammatory nature, an average pustule lasting, from the beginning until the crust dropped off, from two to three weeks. Many new lesions, all strictly pustu¬ lar in character, have from time to time appeared, as a rule, in crops, while the older ones have, at the end of a variable period, disappeared, leaving persistent dark-red, brownish, pigmented marks. No scars remain. One peculiarity of mature pustules has not been referred to, namely, the tendency for the inflamed skin around the crust to pucker, giving the skin a wrinkled, drawn-up, glistening appearance. The disposition of the lesions to group has always been present, though at times only to a slight extent. It has not, however, been observed with all of the lesions, many appearing singly. As they increased in size there would generally be noted a number of discrete or con¬ fluent small, pin-head sized, flat pustules immediately around the circumference of the original lesion in the form of a ring. This feature varied, being much more pronounced in some cases than in others, and at times was wanting. The pustules, how¬ ever, seemed to grow in this manner, a new ring of minute pustular points springing up every few days around the crust until the lesion reached its determinate size. The crusts were adherent; upon lifting them up, a superficial, reddish excoria¬ tion, covered with a slight puriform fluid—as in the case of ecthyma—presented itself. Little or no bleeding occurred. Itching has not been severe, but the lesions have “ felt sore.” Three nights ago he was attacked with violent itching of the general surface, accompanied with an efflorescence which lie describes as having been identical with certain attacks before experienced on several occasions, and which was plainly urti¬ carial in nature. It began, while in bed, upon the arms, but soon extended itself over the whole surface except the hands and feet, the backs, as well as the palms and soles, remaining free. The eruption was erythematous and very red, and exceedingly itchy; so much so that he wTas kept awake all night. The next day the eruption disappeared, but he felt poorly and complained of loss of appetite and malaise. Last night, just after going to bed, it suddenly reappeared in the same manner as two days before. The attack was preceded by chilliness and malaise;
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