Cutaneous manifestations have not received the attention they deserve as signs of activity in rheumatic fever. In a ward epidemic of this disease observed at the Montefiore Hospital during the months of March to November, 1931, ten of twenty-one children showed cutaneous lesions as one of the predominating signs of a recurrence or exacerbation of rheumatic fever.
These lesions were most prevalent during August and September of that year, and they occurred in crops. They appeared mainly on the lateral surface of the legs and on the extensor surface of the forearms. They were rarely seen on the anterior surface of the trunk. The regions about the joints were seldom involved. The lesions were bluish and nontender and varied in size from that of a lemon seed to that of a hazelnut. Most often they appeared as maculopapular purpuric spots and persisted for from one to six months. In fading
CHESTER W, SCHWARTZ SP. CUTANEOUS LESIONS IN RHEUMATIC FEVER: PREDOMINATING SIGNS OF ACTIVE RHEUMATIC FEVER DURING A WARD EPIDEMIC. Am J Dis Child. 1934;48(1):69–80. doi:10.1001/archpedi.1934.01960140078008
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