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September 1946


Arch Intern Med (Chic). 1946;78(3):255-295. doi:10.1001/archinte.1946.00220030002001

INTRODUCTORY AND HISTORICAL NOTES ULCERATIVE  ULCERATIVE lesions of the skin occur frequently in the tropics. There is one type of ulcer, among soldiers who took part in the Pacific island campaigns, from which virulent Corynebacterium diphtheriae was often isolated. This paper is particularly concerned with lesions of this type. Typically, they are deep and have a punched-out appearance. They have been called "ecthyma" by some. This type of lesion is identical with the so-called desert sore of Northern Africa and Asia, of which the diphtheritic origin has been recognized and which frequently occurred in Allied and German soldiers. Evidence will be presented concerning the infected skin as a source of nasopharyngeal as well as cutaneous diphtheria, not only among military but also in large civilian populations to which the military have returned. Aside from these epidemiologic considerations these ulcers are of particular interest since neuritis and myocarditis are among the