Two cases of acute general psoriasis following vaccination / by George H. Rohé.

  • Rohé, George H. (George Henry), 1851-1899.
Date:
[1882]
Catalogue details

Licence: Public Domain Mark

Credit: Two cases of acute general psoriasis following vaccination / by George H. Rohé. Source: Wellcome Collection.

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    His health had always been good, with the exception of a lymphan¬ gitis from a dissecting wound and an attack of catarrhal pneumonia, during the preceding six months, from which he had entirely recovered. His nutrition was fair, but he has been somewhat troubled during the past two weeks with gastric irritability. He is also somewhat run down from over-work in the dissecting room. He has never suffered from any skin affection, or from any recognized manifestation of gout or rheuma¬ tism. According to the best of his knowledge and recollection, his par¬ ents, brothers, and sisters have also always been free from such diseases. About the middle of January, he had been vaccinated with fresh bovine virus, which failed to produce the characteristic vaccine vesicle. In eight or nine days after the inoculation, however, the spot became extremely itchy, red, and covered with white scales, which, on being rubbed or scratched off, were rapidly reproduced. A few days afterward, he noticed a number of small red papules covered with white scales, disseminated over the arms and thighs. The itching increased co-incidently with a rapid spreading of the eruption. The spots enlarged by eccentric spread¬ ing of the primary eruption, and not by the aggregation of single papules. The base of the patches was red and infiltrated, and the covering of white scales very profuse. On the 10th of February, when I was first consulted, the eruption, consisting of the various sized lesions characterizing the typical efflores¬ cence of psoriasis, covered almost the entire body. The extensor surfaces of the forearms, outsides of the thighs, and sides of the trunk were thickly covered with psoriatic papules, spots, and larger patches, while the erup¬ tion on the rest of the body was less profuse. The palmar and plantar sur¬ faces were exempt from the eruption, but the face was pretty thickly covered. Here the scales were constantly removed, and the efflorescence simply consisted of reddened papules and raised spots. The itching was so severe as to interfere seriously with the patient’s rest. There was anorexia, slight fever, and marked lassitude. Some quinine had been taken, but without any favorable effect on the eruption. I, at first, directed five-drop doses of Fowler’s solution of arsenic thrice daily, with calomel ointment to the face to allay the itching. Under the arsenic, the itching and systemic irritation increased, and the disease continued to spread. After about a week the arsenic was discon¬ tinued, and the following mixture, which I have found of service in many cases of acute exudative affections of the skin, was ordered: 5- Potassii acetat., Ext. taraxaci fluidi.. aa | ss. Aquae foeniculi.ad § ij. M. S. Dessertspoonful in half a pint of water four times a day. In addition a daily hot bath, rendered alkaline with carbonate of so¬ dium, was directed. Under this treatment, the eruption at once began to improve, the redness, itching, and the production of scales decreased, and in three weeks the patient was entirely wrell. The dark pigmented patches of the skin, generally remaining after psoriasis, did not entirely disappear for nearly three months. The alkaline baths had also been taken during the arsenical course, so that the good effect of the treatment could not be ascribed to the local remedy alone. Case II.—M. W., white, male, nine years old, of Irish parentage,.