Identifier: practicaltreati00hyd (find matches)
Title: A practical treatise on diseases of the skin, for the use of students and practitioners
Year: 1897 (1890s)
Authors: Hyde, James Nevins, 1840-1910 Montgomery, Frank Hugh, 1862- joint author
Subjects: Skin
Publisher: Philadelphia, New York, Lea brothers & co.
Contributing Library: The Library of Congress
Digitizing Sponsor: The Library of Congress

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in. Levy2 reportsthree instances of total disappearance of pig-ment. It is then, as Kaposi has well shown,that the eye of the observer is struck no longer bythe unusual whiteness of the involved patches,but, this whiteness being generalized and ap-parently that proper to the person, by theintermediate peripheral belts of a deeper andunusual color. The greater portion of the sur-face of the body may finally thus be involved.The most common seats of the disease are theface, the neck, the backs of the hands, and the extremities; and in these, since the course of the disease is exceedinglyslow, there may be for years no apparent extension cf any involvedarea. Upon the backs of the hands the disfigurement is usually moreconspicuous at some seasons of the year than at others, a circumstancewhich probably explains the reported instances of recurrence and totaldisappearance of the disease in successive years. These changes arein part due to the influence of the sweat in washing the pigment to
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v^: ,:- H/1S1 i).: Vitiligo in a negro boy(Piffards case). 1 Louisville Med. News, 1880, x. p. 148. 2 Receuil de Mem. de Med. de Chirurg. et de Pharm. mil., 1865. 492 DISEASES OF THE SKIN. the surface. Such an effect would, of course, render the hyper-pig-niented peripheral zone of a vitiliginous disk much the more con-spicuous. The health of the subjects of this disorder is usually unimpaired.A morbid mental condition is often produced when the disfigurementreaches the facial region, especially in women of middle life. As in several of the other pigmentary disorders of the skin, thepatches of vitiligo may be symmetrical in distribution, with their out-lines limited to the areas supplied by certain nerves. Lesser, however,attributes this peculiarity to the anatomical relations of the skin insymmetrical regions of the body, an explanation which will not sufficefor all cases. The course of the disorder is evidently toward the increase evenwhere all the pigment is not removed from the su

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