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Article
November 1937

LESIONS OF THE SKIN AND SUBCUTANEOUS TISSUE IN DISEASES OF THE PERIPHERAL CIRCULATION: E. D. TELFORD, F.R.C.S. Professor of Surgery Emeritus, University of Manchester FLINTSHIRE, ENGLAND

Arch Derm Syphilol. 1937;36(5):952-963. doi:10.1001/archderm.1937.01480050018002
Abstract

It is evident that continued circulatory deficiency must produce changes in the nutrition of the affected area. The essential change is the development of fibrosis. On clinical grounds these complications of circulatory deficiency may be divided into two groups. In one group, which may be called the "chilblain" group, the lesions are subacute and localized and individually tend to clear up, while in a second group there is a slow persistent and relentless interstitial fibrosis such as is seen in acrosclerosis.

While in the first group it is evident that a defective venous return is the cause, the lesions in the second group appear to arise from an insufficient arterial supply.

GROUP I  The feature of the first group is the formation of subcutaneous nodules, which commonly disappear in time but occasionally break down and lead to a painful and tedious ulceration. The study of these nodules is best begun

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