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January 1929


Arch Derm Syphilol. 1929;19(1):149-152. doi:10.1001/archderm.1929.02380190152015

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A Case for Diagnosis. Presented by Dr. Cole and Dr. Driver.  J. G., a man, aged 39, a laborer, had gone to the hospital three and one-half years before presentation for the treatment of a cough and "stomach trouble." While there, a polyneuritis had developed, which resulted in contractures of the extremities; although there had not been any history of arsenical medication, a generalized brownish pigmentation had appeared and persisted. As presented, the patient was markedly emaciated, with a generalized mottled pigmentation, especially on the trunk. There were a few small keratoses on the palms and soles. The mucous membranes were not involved. There was pronounced muscular atrophy of the extremities. The blood pressure was 84 systolic and 54 diastolic.

DISCUSSION  Dr. Miskjian: The low blood pressure favors a diagnosis of Addison's disease, but the palmar keratoses seem to be of arsenical origin. Possibly this case represents a combination of

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