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November 1928


Arch Derm Syphilol. 1928;18(5):782-792. doi:10.1001/archderm.1928.02380170138017

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A Case for Diagnosis. Presented by Dr. Mitchell.  A man, aged 47, was first seen at the Lutheran Memorial Hospital on Feb. 9, 1928, with the history of a gradual onset of nonpruritic erythematous patches on the scalp, face, neck, back, hands, knees and ankles. The disorder began in the autumn of 1927, and since that time he had been taking medicine of an unknown composition. The physician who had treated him had refused to divulge the nature of the drug. The erythematous areas were bright red and sharply defined. A conspicious feature was the bandlike areas on the dorsal surfaces of the fingers, stopping short at about the same point on the dorsum of the hands. Results of the physical examination was completely negative, as were all the laboratory tests. The temperature varied but never reached more than about 100 F. The blood count was approximately normal, as was the basal metabolism. The internist at the hospital had failed to find any visceral disturbance of any kind. The patient complained of great weakness, and was unable to stand or walk for any distance. He was perfectly comfortable while sitting. During his stay in the hospital he was put on a salt-free diet, and rapidly developed an edema of the extremities. When this was discontinued, the edema improved.

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