. A practical treatise on medical diagnosis for students and physicians . ulcerationand destruction of tissue. The disease occurs especially from puberty tothe thirtieth year, and oftener in men than in women. It develops slowlyand insidiously. Sometimes the first skin-lesion is a crop of bulla?,suggestive of pemphigus. More commonly there appear reddish orviolet-colored patches, varying in size from i inch to 2 or 3 inchesin diameter, and becoming of a darker hue later. The next step LEPROSY. 807 is the formation of nodules, which are characteristic of the may develop upon the p
. A practical treatise on medical diagnosis for students and physicians . ulcerationand destruction of tissue. The disease occurs especially from puberty tothe thirtieth year, and oftener in men than in women. It develops slowlyand insidiously. Sometimes the first skin-lesion is a crop of bulla?,suggestive of pemphigus. More commonly there appear reddish orviolet-colored patches, varying in size from i inch to 2 or 3 inchesin diameter, and becoming of a darker hue later. The next step LEPROSY. 807 is the formation of nodules, which are characteristic of the may develop upon the patches already described, or in other vary in size from that of a pea to that of a birds egg or are most common upon the face and extensor surfaces of the arms,legs, fingers, and toes. The tubercles consist of an infiltration into thetrue skin; they are raised, firm, relatively painless, and vary in colorfrom red to copper. The face is characteristically distorted into a fierceexpression (leontiasis). The tubercles may become absorbed and leave. atrophic areas, but generally they break down into eroding ulcers, whichslowly burrow and increase in extent, eating off a portion of the nose,fingers, hands, and feet, and exposing muscles, tendons, nerves, blood-vessels, and bone. Tubercles form also upon nerve-trunks, and ulcersupon the mucous membranes. (See the Nose and Larynx.) In other cases, or in combination with the tubercles, especially uponthe limbs and trunk, there are ancesthetic areas. Ulcers may follow with- 808 THE INFECTIONS. out the previous occurrence of tubercles. With the anaesthetic patchesare associated crops of bailee and neuritis. The further peculiarities of the disease are : its long duration, its slowprogress interrupted by apparent healing of some of the ulcers ; its afebrilecourse (the temperature is generally subnormal); its comparative pain-lessness, and the slight impairment of the general health. Death results from gradual wasti
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