Excerpt from Clinical Aspects and Etiological Relations of Cutaneous Tuberculosis

It is my function, as I interpret the instructions of the Council, to place the subject in its clinical and etiological relations before you in as simple a form as possible for discussion. Before this body it will be unnecessary more than briefly to indicate those well-recognized conditions of the skin, which have been hitherto assigned a more or less individual or independent position in cutaneous pathology among dermatologists, and which, with certain other less clearly defined conditions, it will be my object to show, are only progressive phases or clinical forms of a single affection.

I. - Lupus Vulgaris.

I may be pardoned if I attempt to define before you the meaning of this term, as ordinarily used, by the briefest sketch of the lesions which characterize its course. The vast and needless number of specific terms which have been invented to express each particular phase of development or involution and every clinical form shows the great diversity of these manifestations. Several distinct types of its primary stages are recognized. The formation of apparent macules varying in size from a point to a pea, or larger areas of irregular outline, neither of which are elevated above the general surface, but are felt to represent infiltrations of the cutaneous tissues of varying depths - L. maculosus, planus. Papules, tubercles, nodules, or much larger areas elevated above the surrounding skin to the extent of a line to a half-inch. Like the former lesions these are found to extend more or less deeply into the skin, and exhibit the same boggy, yielding consistence when pressed upon with any blunt pointed instrument. These constitute L. tuberculosus, nodosus, elevatus, tumidus, non-exedens, non-ulcerosus. A more minute description of these ordinary early lesions, included under the common term lupoma, would be wholly superfluous.

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