Identifier: americantextbook00bang (find matches)
Title: An American text-book of genito-urinary diseases, syphilis and diseases of the skin
Year: 1898 (1890s)
Authors: Bangs, Lemuel Bolton, 1842-1914 Hardaway, W. A. (William Augustus), 1850-1923
Subjects: Urogenital System Urination Disorders Syphilis Skin Diseases
Publisher: Philadelphia, W. B. Saunders
Contributing Library: Columbia University Libraries
Digitizing Sponsor: Open Knowledge Commons

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the blister. Diagnosis.—There should be but little difficulty in differentiating pem-phigus from other diseases occasionally presenting bulla. The studentshould have prominently in mind a few essential facts : First, pemphigus is acomparatively rare disease. Second, it generally runs a subacute or chroniccourse; the bullse, as a rule, spring from apparently healthy skin; inflam-matory symptoms are rare and slight. The eruption has no predilection forany locality. And lastly, a true pemphigus bulla never ulcerates or healsby cicatrization unless it has been subjected to traumatism. The only cutane-ous change after involution is pigmentation, varying in degree as regardscolor. The diseases that may be mistaken for pemphigus are herpes iris, urticaria,pustular and bullous syphilis, scabies, impetigo, eczema, and bullous varicella. Pemphigus may be differentiated from herpes iris by remembering thatthe latter rises from an inflammatory base, and that the vesicles do not return Plate 16.
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Pemphigus vulgaris (drawn from life). PEMPHIGUS. 837 when they have once disappeared. Herpes is acute; the lesions consistessentially of vesicles which by coalescence may become bullae. Further,the vesicles of herpes iris are arranged concentrically, and situated usuallyupon the arms and hands. Urticaria is to be known from pemphigus by the fact that it shows signsof inflammation and the presence of wheals. Bullous or pustular syphilis is rare, and occurs in infants who are thevictims of the inherited disease ; the bullae are situated over an exulceratedbase which dries into a thick brownish or green scab. The history and othersyphilitic symptoms will also aid in diagnosis. Scabies has characteristic symptoms of its own which will render differ-entiation easy. In eczema the occasional bulla is generally accompanied by other charac-teristic symptoms of eczema. The raw weeping surface of eczema rubrummight suggest pemphigus foliaceus, but observation for a short time willreveal the half

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