Transactions of the American Association of Obstetricians, Gynecologists, and Abdominal Surgeons for the year ... . ted excoriations from coituswith resulting chronic wound infection. (1) When we consider that the negro makes up but one-tenth of thepopulation of this country, it is striking that, practically, all these 166 HYPERTROPHIC-ULCERATIVE CHRONIC VULVITIS 167 cases of vulvar hypertrophy in American literature are found amongcolored women. Steins two cases, Gallaghers four cases and the13 cases considered in the present report were all negresses. In factI can recall having seen but one
Transactions of the American Association of Obstetricians, Gynecologists, and Abdominal Surgeons for the year ... . ted excoriations from coituswith resulting chronic wound infection. (1) When we consider that the negro makes up but one-tenth of thepopulation of this country, it is striking that, practically, all these 166 HYPERTROPHIC-ULCERATIVE CHRONIC VULVITIS 167 cases of vulvar hypertrophy in American literature are found amongcolored women. Steins two cases, Gallaghers four cases and the13 cases considered in the present report were all negresses. In factI can recall having seen but one such case in a white woman, a prostitute,in whom, moreover, an admixture of negro blood was suspected. Eventhe filarial form of elephantiasis of the vulva has been noted primarilyin the colored races. In European literature the condition has beenfound almost exclusively among prostitutes. That this tendency to>fibrous hypertrophies of the vulva among colored women has somerelationship to the similar tendency to keloids and uterine fibroids inthis race, seems more probable. There can be no question as to the. Fig. 1.—(Case 11) Combination of ulcerative and nodular form of chronic hypertrophic vulvitis. On the left side we see beginning hypertrophy with extensive ulceration. The right hand picture was taken 2T/2 years later and shows the continued ulceration with marked hypertrophy of clitoris and right labia. pronounced racial predisposition to this condition existing among thenegroes. I have seen neglected syphilitic ulcerations in white women,even prostitutes, produce only slight thickening or edema of the labia,Avhile in the negress there usually developed a considerable penduloustumor. (2) The anatomic distribution of the lymph channels of the vulvapredispose to lymph stasis. In filarial infections, the occurrence of alymphatic enlargement in the inguinal and femoral region not onlyblocks the flow to the leg, but also to the labia on the same side,Koch has reported case
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