Massive destruction of the face is rather a rare condition. A diversity of etiologic factors have been given credit for its production. Among the principal causes of the condition are syphilis, frambesia, extensive rodent ulcer, tuberculosis, leishmaniasis (American), leprosy and gangosa (probably a tertiary form of frambesia).
The two main possibilities to be considered in the case to be reported are syphilis and American leishmaniasis. In America it is hard to prove that a case is one of leishmaniasis. It may have all of the typical findings, and yet the etiologic factor cannot be demonstrated. We observed such a case in the Kansas City General Hospital for nine months, in consultation with Dr. Paul F. Stookey.
The patient was a Central American who came to the hospital because of a perforation in the septum of his nose and a fissure at the junction of the left nostril and the lip.
DENNIE CC, HAMILTON TR, QUINN HF. MASSIVE DESTRUCTION OF THE FACE. Arch Derm Syphilol. 1940;42(6):1040–1045. doi:10.1001/archderm.1940.01490180049003
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