Dr. James Galloway showed the case of a young lady presenting an eruption on the left arm of unusual character. The lesion in some respects resembled those of granulomatous origin, but no definite diagnosis was given. This case will be subsequently noted in full.
Dr. T. J. P. Hartigan (introduced) showed a case of atrophy of the nails, a description of which will be found on page 147.
Dr. Graham Little showed: (1) A case of a corymbose syphilide in a man aged 44 years, with a history suggestive of a double infection with syphilis. The patient had been in the Army and had contracted syphilis in India, twelve years ago. He then had a chancre on the top of the glans penis, the scar of which was still visible. He was taken into the Military Hospital and treated for exactly ninety-seven days, his treatment ceasing entirely after this period. He had no secondary eruption and no further symptoms. Eight years later he had another chancre, also on the glans penis, but near the frænum. This was, according to his description, a deep ulcer, which was seven weeks in healing. He had no bubo following and no secondary eruption. Ten weeks ago he began to have the present eruption, which was the only general rash he had ever had. With the exception of the treatment during the actual presence of the two chancres, he had had no specific treatment whatever.
The eruption as seen on exhibition consisted of numerous groups of fairly large papules arranged in a somewhat herpetiform manner, with here and there a central larger papule surrounded by smaller ones, in the manner described as corymbose, but for the most part the groups were composed of papules equal in size; these groups were scattered over the back especially, the chest, the arms, the thighs, and the face, with individual large papules here and there upon the arms and legs. The mucous membranes were not affected.
The history seemed to point to a double infection, the interval between the two chancres being eight years.
(2) A case of dermatitis artefacta in a young lady, a private patient, who gave the following history. She was bitten by an old collie dog twenty-three days ago on the calf, through her dress. She was not seen by a doctor until a week or more later, and when seen by him she had a circular “patch upon the calf of vesicating erythema, surrounding the bite, with a vivid erythematous non-vesicating ring, about half an inch broad, surrounding the central patch, and separated from it by an intervening band of healthy skin, about a quarter of an inch broad.” Four days later an exactly similar condition was noted on the lower part and inner aspect of the same leg, “a patch of vesicating erythema the size of a florin, surrounded immediately by healthy skin and then a ring of vivid erythema half an inch wide.” The patient did not appear to be in any way neurotic. There was no apparent animus against the owners of the dog, who were old and intimate friends, and no breach of relations between them had taken place. She led a healthy active life and was, in fact, in robust health at the time. The ointment used in the first instance was obtained from a chemist; her doctor had prescribed carbolic ointment. The method of production was not ascertained and no adequate motive could be assigned.
(3) A case which was shown as syringomyelia with trophic ulcers on the upper arm and shoulder in a woman who had been under Mr. Ernest Lane’s care for about twelve years, and had had numerous operations performed for a continually ascending necrosis of bone accompanied by trophic ulcers on the skin.
Some divergences of opinion were expressed as to the diagnosis, and this being at any rate a rare and interesting case, a more detailed report will be subsequently submitted for publication in this journal.