The ætiology of psoriasis, whether of the skin or mucous membrane, has been, and is still so hotly discussed, that the translator can but mention the author’s conclusion that the pathological picture of his case points anatomically to an inflammatory origin, and ætiologically to a parasitic origin of psoriasis.
J. L. B.
ERYSIPELAS NEONATORUM GANGRÆNOSUM. E. Nohl. (Münch. med. Wochenschr., September 13th, 1904, p. 1648.)
The child was born on February 29th, and was apparently healthy at birth; she developed diarrhœa on the fourth day, and redness and swelling of the genital region on the sixth.
Seen for the first time on March 7th, the labia majora were much swollen, red and shining and painful. Both thighs presented a firm œdema and looked blue and marbled. There were frequent motions like pea-soup. On March 9th the temperature rose above normal for the first time and, with the exception of the first two evenings, when it sank below normal, it remained elevated till the child died, reaching 40° C. on March 11th, and 40·5° C. on March 15th.
On March 12th a large ulcer appeared on each labium following a bullous upheaval and casting off of the epidermis, and at the same time the skin over the trochanteric region on each side commenced to necrose. The œdema had involved the whole of the lower extremities, the affected parts being pale and flecked with blue; small bladders filled with yellow serum appeared on the dorsal surface of each foot.
Fresh areas of necrosis developed. The ulcers on the labia turned black. On March 15th the child died, with symptoms of meningitis. A post-mortem examination was not allowed.
The author discusses the differential diagnosis between erysipelas and œdema neonatorum. He quotes a passage from Strümpell, as well as a case of his own, to show that fever sometimes appears after the eruption in erysipelas. He further records the fact that there had been a great deal of infectious illness in the house before the birth of this child—severe measles, whooping-cough complicated by empyema, ulcerated throats with otitis media—whilst the mother developed parametritis on the second day.
W. B. W.
Footnotes