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The patient is 40 years of age. The disease from which she suffers began about three years ago upon the right cheek, whence it has spread toward the upper lip. There is much infiltration in the affected part, and exterior to the edges of the main patch are a number of tubercles of glutinous appearance. These tubercles project slightly above the general surface. The extensive and continuous patch upon the cheek is the result of the coalescence of many tubercles. Most of the cheek has been invaded in this manner. Upon the seat of disease are many fine scales. The development of these lesions has, from the first, been accompanied by considerable pain.But the disease is not in active progress in all parts. Upon the cheek are several cicatricial spots. I know, therefore, that however chronic, disfiguring or deep this ulceration, it can not be of malignant
SHOEMAKER JV. LUPUS VULGARIS—EPITHELIOMA—ACNE —ALOPECIA CIRCUMSCRIPTA—TINEA VERSICOLOR.. JAMA. 1898;XXX(11):580-583. doi:10.1001/jama.1898.72440630006001c