[PDF][PDF] Acanthosis nigricans

GB Dowling, W Freudenthal - 1938 - journals.sagepub.com
GB Dowling, W Freudenthal
1938journals.sagepub.com
Discussion.-Dr. F. PARKES WEBER said he thought that the case represented the so-called
complete" hidebound" type of scleroderma which one read of in the old books, one of the
earliest recognized types of the disease. There were, however, some particular points about
the present case which impressed him very much. There was the" pseudo-leprous"
appearance of the ears; he could think of no better term to apply to them. The condition
looked like tuberculous leprosy. Then the eyelids were definitely affected in the same way as …
Discussion.-Dr. F. PARKES WEBER said he thought that the case represented the so-called complete" hidebound" type of scleroderma which one read of in the old books, one of the earliest recognized types of the disease. There were, however, some particular points about the present case which impressed him very much. There was the" pseudo-leprous" appearance of the ears; he could think of no better term to apply to them. The condition looked like tuberculous leprosy. Then the eyelids were definitely affected in the same way as the skin. He did not think that the tongue and the soft palate were of the hard consistency of the skin, but they certainly were definitely involved in the disease, and their movement was impaired.
He thought that the" rain-drop" depressions in this case marked minute areas of the skin in which there was less sclerodermatous thickening than in other parts. Dr. MACCORMAC said a section had been taken through the" raindrop" depressions. Speaking without being certain of the facts his impression was that the same changes were present in the skin, though a little less marked. lDr. C. H. WHITTLE asked whether, in view of the comparative comfort in the face since the extreme swelling had subsided, Dr. MacCormac could give any idea as to the prognosis? Dr. MACCORMAC said that he had only seen two similar cases and so had not much experience on which to base a prognosis. The aedematous reaction was clearing up without developing into the peculiar hidebound condition which was a feature of the more severe types. So far as he could judge, it seemed reasonable to expect that the patient would continue to improve and possibly recover completely. The PRESIDENT said that some years ago he had had a similar case in a man aged over 60, in which the condition had cleared up almost completely, leaving merely a certain number of sclerodermatous areas in the skin which however did not affect the patient's general health. The man regarded himself as cured, notwithstanding the hidebound areas of skin over the ribs and in the lumbar regions. He had remained well for some years afterwards. Dr. WHITTLE asked whether there was any correlation between the rapidity of the spread and the benign character in this case?
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