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A Case for Diagnosis. Presented by Dr. C. J. Shepard, Columbus.
A white woman, aged 40, developed a small white lesion on the tongue about two years before presentation, which resembled a patch of leukoplakia. It increased and new, tender and sensitive lesions subsequently appeared both on the tongue and on the buccal mucosa. About four months later a "fever blister" appeared on the lower lip which rapidly covered the whole lip with a thick crust with a raw, bleeding underlying surface. This condition slowly subsided, but the gums and tongue still show some inflammation. During this time, probably ten or twelve glistening papular lesions appeared on the feet and hands, with a thickening of the nails of both big toes. Smears from the mouth were negative for Vincent's angina and Monilia infection. Pernicious anemia was suspected but examinations of the blood gave negative results. Biopsy was performed on a