Lupus

There are three principal forms of this disease - the superficial variety, commonly spoken of as lupus erythematosus; the deeper, or lupus vulgaris; and the deeply destructive form, or lupus exedens.

These three varieties present certain features in common, and their color is peculiar. It is neither the frank red of an active congestion nor the brownish ham-color of syphilis, but rather the vinous color that derives its hue from chronic venous congestion, mingled with a certain amount of red. The lesions are few in number; often but a single lesion may be present, but quite frequently we may find two or three - rarely more. Their course is chronic, years being devoted to their development. They almost always leave scars, even in the absence of ulceration. The local symptoms are insignificant, as there is rarely either pain or itching, at most a slight burning sensation, to which the patient becomes habituated and ceases to notice. In the patient's family history, pulmonary phthisis is an almost constant feature.



Several years ago Bazin and Hardy gave the name of scrofulides to these affections, recognizing at that time their dependence on the general constitutional condition that predisposes to tuberculosis. Quite recently, the bacillus tuberculosis has been found to be a constant accompaniment of the lesions, thus demonstrating the soundness of the opinions advanced by the eminent dermatologists above mentioned.