Why Willan and Bateman are to be disallowed their just claims in respect to herpes iris, especially in the face of Bazin's honest admission of his non-recognition of the disease in his first account of hydroa, of the correctness of their original description, and the fact that herpes iris has not yet been shown to be clinically the same as Bazin's ordinary phase of hydroa vesiculeux, is to me a matter of surprise. I hold that the term herpes iris should be maintained in use for that form of disease which Willan and Bateman so admirably depicted and originally defined by that designation. It would appear from the experience of most of those who have written about hydroa that the herpes iris of Willan and Bateman is an extremely rare disease. A recent American writer says, "It is known mostly in text-books, and hence the acceptance of inaccurate statements about it." But this is not my experience, though it is by no means a common affection. In none is the disease like the simple variety of hydroa of Bazin. Now and again in its ill-developed or abortive form herpes iris assumes, as noticed by Willan, rather the aspect of an erythema iris, though potentially this condition is vesicular; usually, however, it presents all the features described by Bateman. We have seen it associated at different times with all degrees of severity of herpes facialis,[1] from the simple herpes labialis to the condition in which a considerable portion of the surrounding cheeks, the nostrils, the mouth, the fauces, and anterior aspect of uvula are studded with vesicles; with herpes preputialis;[2] and with non-parasitic herpes circinatus of different parts of the body, proving clearly that the statement that "it has almost certainly no real relation with the other forms of herpes" to be incorrect.[3] I have drawings of cases substantiating this point. It particularly affects the back of the hands, fingers, and wrists, and knees and insteps also, as a rule, and it not rarely exhibits a peculiarity of slight hemorrhagic exudation,[4] which accounts for the livid or dark-purplish aspect of its hue, and the fading away of its several rings just as does a bruise.
Excluding, then, the herpes iris of Willan and Bateman as a distinct clinical eruption, we hold that there is a residuum of Bazin's hydroa vesiculeux, as originally depicted, which deserves some such name as that of hydroa simplex. But Bazin's account of this disease, which I propose to name H. simplex in place of H. vesiculeux, is too limited. My hydroa simplex has the general features
- ↑ Bateman, loc. cit., p. 242.
- ↑ Atlas of Skin Diseases, by Tilbury Fox, M.D., F.R.C.P., Churchill, 1877, p. 45.
- ↑ For a marked case of this, see British Medical Journal, November 6, 1878.
- ↑ I have lately seen a young girl who applied to me for a typical attack of slight erythema papulatum of the backs of the forearms. The half-dozen spots on each arm were very characteristic, and did not take on the iris form in any degree. On the third day afterwards she presented herself again with a fully developed herpes of the lip. The eruptions faded in a few days. It seems to me that such cases are very important connecting links, showing that the herpes iris of Bateman is really a member of the erythemata through erythema iris.—T. C. F.
