On the existence of 'dermatitis herpetiformis' (of Duhring) as a distinct disease / by L. Duncan Bulkley.

  • Lucius Duncan Bulkley
Date:
1886
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Licence: Public Domain Mark

Credit: On the existence of 'dermatitis herpetiformis' (of Duhring) as a distinct disease / by L. Duncan Bulkley. 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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    7. It usnully pursues a clirouic, variable course, lasting years, iind is very rebellious to ireatinent. In one of his later coniniunications, he claims that many similar forms of eruption, reported with various titles, by different observers, are all merely instances of one jirocess, namely, dematitis herjietiformis as he has defined it. Thus, he mentions herpes circiuatus bullosus, jiemphigus prurigineux, herpes gestationis, pemphigus circiuatus, henies ])hlyctie- nodcs, pemphigus aigu prurigineux, certain cases of hydroa, and other eruptions.' Such being the deseription, in brief, given by Dr. Duhring, of what he eonsiders a distinct disease of the skin, capable of demonstration, it remains for us to consider the grounds for this position, and the objec- tions to the same. The first point which must strike everyone is that emphasized by the author, namely, the multiform character of the lesions and the variety of manifestations, which are included as belonging to One disease. But this need by no means be considered a valid objection to its acceiitance, for we all recognize at once the very great variety of appearances which may be presented by eczema and scabies, and also those which have been de- scribed under erythema multiforme, and also the marvellous variety of cutaneous phenomena exeited by syphilis; so that, provided the lesions can be shown to be related to one another, or to depend upon the same eause, or to have the same pathology, their multiformity of ajipearance need be no valid objection against their constituting a single and well- defined disease. Dr. Duhring states that he has watched some of these cases over a period of years, and that his description is written from a prolonged study of some sixteen or seventeen cases, a number of which he has given in detail in various publications. But more serious questions arise in regard to the adoption of “der- matitis herpetiformis ’’ as a distinct disease with the name and descri[)- tion already given, which may be considered under three heads. 1. Have we here to do with a separate disease, possessing uniform characteristics and causes, upon whieh a sound pathology and treatment can be based? 2. Do we advance any nearer a right understanding of the nature, eause, and cure of these cases, many of which have been classed with other affections, by grouping them together under a single name? ' The Medical News, Philadelphia, November 23, 1884, and October 17. 1885. * Philadelphia Medical Times, July 12, 1884. The Medical News, Philadelpliia. July 19, 1884. The New York Medical Journal, July 19, 1884. Journal of Cu- taneous AND Venereal Diseases, New York, August, 1884. The New Yoi k Medical Journal, November 15, 1884. The Medical News, Philadelphia. March 7. 1885. Amen Jour. Med. Sci., January, 1885.