Reports of chronic ulcerations of the skin in which the streptococcus plays a primary etiologic role cannot be found in the literature. Fissure and intertrigo with their occasional concomitants chronic recurrent erysipelas and lymphangitis, as Barber1 pointed out, have been viewed heretofore as the most chronic lesions produced by this organism. The dermatoses of streptococcus origin are mostly acute or subacute and superficial. Even in ecthyma, as Sabouraud2 emphasized, ulceration in the true sense does not occur, and as in other streptococcic pustular dermatoses the organism is simply present in the purulent exudate and ceases to act when free drainage and cleanliness by locally applied antiseptics are brought about and maintained for a shorter or longer period.
The type of ulcer which forms the basis for this report is apparently unique in that it was produced by streptococci, presented features of chronicity both clinically and histologically and occurred
GOODMAN MH. CHRONIC STREPTOCOCCIC ULCER OF THE SKIN: UNRESPONSIVE TO LOCAL THERAPY BUT CURED BY SULFANILAMIDE: REPORT OF TWO CASES. JAMA. 1938;111(16):1427–1431. doi:10.1001/jama.1938.02790420007002
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