Aural Clinic of New York Eye and Ear Infirmary

1886 Boston Medical and Surgical Journal  
fatal as that of this variety of pemphigus. A small excoriated region in the armpit, one or two bullae on the mucous membrane of the lips, even in persons of the most robust type, are sufficient in such cases to warrant the prognosis of a fatal termination of the disease in the course of a few months. The clinical signs of the disease are as follows : The first cutaneous manifestations consist in bullae about the size of peas, the epidermal covering of which is wrinkled and only becomes tense
more » ... th increase of the subjacent exudation of fluid, which fluid is of a dull white color. Upon removal of the epidermal covering there is to be seen in the centre of the exposed excoriation a slight elevation which rapidly increases in size, so that in a short time, there are formed uneven, carunculated, wart-like growths, surrounded by a ring of excoriation, which in its turn, is surrounded by a zone of epidermis which has been lifted from its bed by the exudation of fluid. This process of sub-epidermal exudation spreads in serpentine curves from the excoriated region as a centre. From the surface of the above, red-colored, slightly elevated, and wart-like patches, is exuded a thin, badly-smelling fluid of alkaline reaction, which dries to a thin crust, the removal of which exposes an uneven surface partially covered by a thin, unstable film of epidermal detritus, and is, in part, excoriated. In this manner may be affected in women, the labia majora and minora, the mucous membrane of the mouth and lips, the skin of the axillae, of the folds of the nates, the mucous membrane of the vagina and rectum. In the male, together with the mucous mem-
doi:10.1056/nejm188604221141604 fatcat:vf4x6dnbtfethftdey2jbiewlm