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July 1938


Arch Derm Syphilol. 1938;38(1):142-155. doi:10.1001/archderm.1938.01480130145020

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Syringomyelia with Malum Perforans in Brothers. Presented by Dr. Frank C. Knowles, Philadelphia (from the service of Dr. H. A. Reimann, Jefferson Medical College Hospital).  R. D., a white man aged 24, and H. D., his brother, aged 27, exhibit similar neurologic and cutaneous changes. The condition had its onset in R. D. at 17 years and in H. D. at 18 years. The first sign in both patients was a small blister on the sole; this enlarged and became an open sore, and through it a small piece of bone was extruded a month or so after onset. At the beginning there were moderate pain and redness of the foot, and the patients could differentiate heat and cold on the sole. As destruction continued, sensation of temperature and of pain disappeared, except for slight discomfort if the patient persisted in walking while sequestrums were extruding. As pieces were extruded,

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