Erythema elevatum diutinum / by H. Radcliffe Crocker and Campbell Williams.

  • Crocker, H. Radcliffe (Henry Radcliffe), 1845-1909.
Date:
[1894]
Catalogue details

Licence: Public Domain Mark

Credit: Erythema elevatum diutinum / by H. Radcliffe Crocker and Campbell Williams. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

    15/20 (page 11)
    striking feature in the disease, and on the whole greatly exceeds the tendency to involution. While the primary tint of the lesions is pink, they soon acquire a purplish hue, which becomes more marked the longer the duration of the lesions ; how very long that may be, is strikingly shown in Bury’s and the unpublished case, well earning the title of ‘ diutinum’, or persistent. The older lesions become much firmer to the touch, almost cartilaginous, but at no time are they otherwise than firm and incompressible. The sharp line of demarcation between the diseased and healthy skin is to be noted. There can be no question about the identity of the nature of these two published and the one unpublished case, but with regard to Mr. Hutchinson’s type, the differences between that and what in justice to the first recorder I may call the Bury type, are considerable, and we may compare them in parallel columns as follows:— Bury Type. All Females. All Young. Gouty or Rheumatic in Self or Family. Lesions situated over articulations and on the palmar surface. Began as nodules, but became con- fluent, still showing nodular character. Erythematous at first, but becoming purplish. Lesions, some very persistent, others involuting. Never spread over a large area. Lesions paled but very firm, and other- wise unaffected by pressure. Hutchinson Type. All Males. All Elderly. Very Gouty personally. Lesions not any special localization or over flat bony surfaces. Began as flattish nodules, became con- fluent, and lost their nodular character. Purplish from the first. All lesions persistent throughout life, and spreading widely. Lesions paled only at the border. The elevation was chiefly due to oedema, and could be almost removed by continued pressure, and there was oedema in the neighbourhood. The two types differ in the age and sex of the patient, in the position of the lesions, and in the older cases the nodular character was less developed, being cedematous, and lacking the firmness of the Bury type of the nodules and patches. They resemble each other in the gouty diathesis of the patients, their being primarily nodular in character, becoming confluent and