Transactions of the American Dermatological Association (Volume 26) (Paperback)

This historic book may have numerous typos and missing text. Purchasers can download a free scanned copy of the original book (without typos) from the publisher. Not indexed. Not illustrated.1903 Excerpt: ... groups, situated on the outer side of the middle of the upper third of the arm, was excised and examined. Before describing the specimens, permit me to recall for a moment the picture ordinarily presented in zoster--such a picture as that shown in Fig. i from a case of zoster lumbalis. You see a cutis moderately infiltrated with round cells along the lines of the blood vessels, and a rete in which, in a circumscribed region, there is a peculiar degeneration resulting in the formation of a characteristic multichambered vesicle filled with sero-fibrinous fluid and containing leucocytes and epithelial cells, many of which show peculiar degenerative changes, which have been the subject of much discussion and which need not detain us here. The changes in the rete begin in the lower tiers of cells, and the roof of the vesicle is formed by the horny layer, the entire vesicle lying within the rete. The degree of small-cell infiltration in the cutis varies in different cases quite independently, I have noticed, of the clinical symptoms of inflammation. In some cases, apparently mild, I have seen the cutis the seat of an infiltration extending with interruptions from the hypoderm to the epidermis, and involving most markedly the coil glands, the pilo-sebaceous apparatus and the papillary and subpapillary layers. On the other hand, I have seen cases of severe confluent and haemorrhagic zoster in which the infiltration seemed disproportionately small and was almost limited to the subpapillary layer. It would seem from this observation as if the small-cell infiltration were the direct effect of the primary lesion of the disease--be it nervous or vasomotor--rather than the reflex and secondary effect of the lesion in the epidermis. This view that the primary or central l...