The general consensus of opinion was that this was a case of Lichen planus.
Mr. T. J. P. Hartigan showed (1) a case of tertiary syphilis in a man, aged 90 years, with a history of ten years’ duration. It was recorded by Mr. Waren Tay, to whom the exhibitor was indebted for the case, that “there is a very warty patch on the tip of the elbow, the papillæ and epidermis being enormously hypertrophied. Adjacent is a horse-shoe patch, suggesting tertiary syphilis. There are no other patches, and only doubtful evidence of slight scarring, and of its serpiginous character. It is stated to have followed a blow which caused an abrasion, and that, working with his sleeves up, he often knocked the elbow.” A histological examination showed a granulomatous infiltration of the corium very suggestive of syphilis, and there had been marked improvement under potassium iodide. The case was interesting as showing (a) that extreme old age was no bar to the occurrence of gummata, and (b) the enormous hypertrophy that may accompany the condition.
(2) A case of atrophy of the nails following measles in a girl aged 18 years. Three months after the exanthem all the nails were shed, and subsequently regenerated, except in the case of the thumbs, both index and middle fingers and the big toes, where they were either very thin, striated, and longitudinally fissured, or apparently absent, the posterior nail-fold having grown forward and become adherent to the nail-bed, through which more or less of the root of the nail could still be felt. No member of her family had any affection of the nails. There was no evidence of syphilis, and she had never had any other illness. The condition had persisted for thirteen years.
Dr. R. L. Bowles remarked that anything which lowered the vitality of the system might produce various abnormalities of the nails, and he quoted the observations of Sir Samuel Wilks who had seen atrophy of the nails after scarlet fever.
(3) A case of ulcer of the cheek in a man, aged 52 years, of four months’ duration. It was roughly circular in shape, at least 1 cm. in diameter, and scabbed over. The glands were not enlarged, and there was no evidence of syphilis. If it should turn out to be a rodent ulcer, he thought it was unusually rapid in its growth. He proposed removing it entirely, and he would report on it histologically at a subsequent meeting.
(4) A case of acute Lupus erythematosus in a married woman, with a history of five months’ duration. It began as two small patches on the cheek in front of the right ear and extended to the face, the pinna and concha of the ear, and the neck. Soon after, the fore-arms and and backs of the hands and fingers became affected. The scalp was very scurfy, and at one time she was much exposed to the sun. There was scaling, but no vesication or evidence of atrophy. There was a good deal of pain and tenderness, and she was quite unfitted for work.
(5) A case of congenital pigmented nævus in a girl aged eleven years. There were numerous small, dusky, pigmented patches and spots scattered upon the left side of the neck, shoulder, and breast. There were also a few spots on the lobule of the corresponding ear. They were said to be getting darker, and some were becoming papillomatous. They were thickly grouped around the nipple, the areola of which was deeply pigmented. There was also a patch of dark hair behind the ear on the same side.
(6) A case of acquired pigmented nævus in a boy aged 11 years. Two years ago he noticed a freckle beneath the left eye which gradually became darker, and it was now black. Four more soon followed immediately below the first, and then another appeared on the lower lip on the right side. Other spots were to be found on the trunk and neck.
Among the suggestions for treatment put forward by the members of the Society excision of each nævoid spot was mentioned as being the most efficient method of radical cure.