Acne atrophica or lupoid acne / by L. Duncan Bulkley.

  • Bulkley, Lucius Duncan, 1845-1928.
Date:
[1882]
Catalogue details

Licence: Public Domain Mark

Credit: Acne atrophica or lupoid acne / by L. Duncan Bulkley. Source: Wellcome Collection.

    4/4 (page 22)
    formed from inflamed points, similar to those present, which came and went slowly. He was placed upon the same internal medicine as the former cases, and locally was given a lotion of sulphuret of potassium, zinc, and rose¬ water. One month later, it was recorded that most of the eruption had disappeared, although he had been a little irregular with the medicine. Two weeks later, no inflammatory elements were present, and the scars were becoming pale. Two weeks later still, it was noted that there had been a return of the eruption in the shape of a single, small, inflamed point on the right side of the tip of the nose which was crusted, and exhibited a hole when this was removed; there was also a small lump on the left side of the nose, but none on the forehead or elsewhere. Case III.—William T. -, aged twenty-seven, had had an eruption of acne on various portions of the face for a number of years, but it had not caused permanent scars until the past three or four years, when the character of the eruption changed somewhat. His general health was reported as good, with a slight tendency to constipation, and a pale and lightly coated tongue. The principal location of the eruption in this case was the forehead which was covered with inflamed and indurated points, many of them ulcerated and many scratched. Between them were many small, round¬ ish, depressed scars, suggesting syphilis or small-pox: the lesions present and the cicatrices resembled exactly those described in the two preceding cases. Bemarks.—Although I have not made any microscopical studies in these cases, to demonstrate that the lesions were connected with the sebaceous.glands, I have no hesitancy in regarding the eruption under consideration an acne, because of the clinical features presented, the history of the cases, and the ease with which the condition yields to ordi¬ nary acne treatment. I do not, however, place these cases in the same group as those instances of acne simplex in young persons, where there is often more or less scarring in connection with the ordinary inflammatory pustules of this and acne indurata; in these instances the scarring results from the direct destruction of tissue by the suppurative process. In the cases under consideration the conditions seem to be different. This form of eruption is commonly seen in more advanced life; the pro¬ cess is a very chronic one, the grade of inflammatory action is a very low one, and the production of cicatricial tissue seems to be rather the result of altered nutrition and absorptive action than from the severity of the inflammation. Whether the process is allied to lupus, I cannot state; it has some¬ times been spoken of as follicular lupus, but I doubt the propriety of classing it as such, inasmuch as the line of treatment required is so radi_ cally different from that called for in this latter disease; no true lupus nodules are ever seen. Certainly it has no relation to syphilis, although the lesions and the scars suggest it most forcibly. The eruption seems to be more common in men than women, although I have observed it a number of times in females.