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September 17, 1887


JAMA. 1887;IX(12):376. doi:10.1001/jama.1887.02400110024005

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Mr. Jonathan Hutchinson has recently drawn attention to a disease which, he believes, up to the present has not been recognized. It is a form of inflammation of the lips and mouth in which superficial ulcerations occur, followed sooner or later by some form of skin disease and leading to a fatal termination. The exact form of skin disease varies, but the hands and feet are the parts usually affected, the nails being especially prone to suffer. In some cases the eruption may consist of bullæ, followed by free papillary outgrowths. No special antecedents can be alleged as the probable cause of the malady, but the disease has only been observed in middle life or in early senile periods. If not checked by treatment the disease appeared to run its course in about six months, death being produced by exhaustion. Mr. Hutchinson considers that opium given in repeated doses will

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