ORIENTAL SORE

D. KING SMITH
1922 Archives of Dermatology and Syphilology  
Oriental sore is endemic in Asia, Africa, South America and southern Europe. The lesion is caused by Leishmania tropica. Infection is conveyed to the human subject through abrasions or small wounds, probably by insects. Autoinoculation is common. Early stages show nodules, which break down to form ulcerating and vegetative lesions. Clinically, one finds that after an incubation period lasting from a few days to several weeks, one or more itching spots appear on uncovered parts of the skin.
more » ... s of the skin. These lesions become indurated; and may develop to the size of a bean. The nodule then breaks down, forming an ulcer which becomes crusted. The edges of the ulcer are sharp, the base irregular and covered with yellowish-red granulations. After an indolent course, the ulcer heals by scar formation. The following cases came under my observation last summer : REPORT OF CASES Case 1.\p=m-\History.\p=m-\D. E., aged 4 years and 2 months, had a hard papule about the center of each cheek, which the mother noticed while in Bagdad, about February 10. Six weeks later, one appeared also on the tip of the left ear. The papules soon broke down, developing into running sores. Examination.-June 28, the lesions presented the following characteristics : Those on the face were annular and abolit half an inch in diameter, with a well marked inflammatory areola. The crust was of a dark color and very adherent. On removal, there was no pus, but a dark red granular base, showing considerable ulcération. The lesion on the ear showed much destruction of tissue, a large part of the area being covered with a crust similar to those on the face. There was no glandular enlargement. Except when the lesions were rubbed or struck, there was no pain. Treatment.-During the first two weeks, while under my care, boric acid compresses were applied during the day and ammoniated mercury, 10 grains to the ounce of petrolatum at night. There was no evidence of improvement under these applications. A 5 per cent, argyrol solution was used over a period of two weeks, with no improvement. The patient had three roentgenray treatments and one injection of 0.25 gm. of novarsenobenzol (Billon), a brand of neo-arsphenamin. One week after the injection, the crusts on the left cheek and ear became detached, leaving healthy looking ulcers. A week later, the crust on the right cheek also became detached. Four weeks from the time of the injection, all of the sores had healed, with marked scar formation.
doi:10.1001/archderm.1922.02350260072007 fatcat:tzq5qnpxdjd4fcx6xyef2qjkz4