HYPERTROPHIES AND ATROPHIES. 87
HYPERTROPHIES AND ATROPHIES.
LOUIS A. DUHRING, M.D.
Extraordinary pigmentation of the skin in pregnancy. — Dr. McLane's case occurred in a woman at the eight month of her third pregnancy. The pigmentation exhibited itself in patches varying in size from one inch to six inches square, the largest patches being upon the neck, the back, and the thighs, in which localities the skin was very near the color of that of a negress, and made a very striking comparison with the light skin of the blonde. In her second pregnancy the skin became slightly pigmented in spots, which remained for some months after delivery, finally disappearing entirely. There was no unusual pigmentation about the nipples, nor along the median line of the abdomen. The patient was un- usually anaemic for a woman in pregnancy; beyond which no cause could be assigned for the manifestation. — American Journal Obst., Oct. 1878.
Melanoderma. — Dr. George Gaskoin reports the following case: The i)atient was a woman, aged 45. The patch was situated on the cheek, near the nose, and was about the size of a half-dollar and well defined. The color was intensely dark. The patient had undergone a previous change, at the age of 30, in the color of her hair, which had turned from a carroty red to black. The patch on the cheek began nine years later. All of her near relatives, except her father, were of light complexion, with red hair and light eyes, — British Medical Journal, April 19, 1879.
Scleroderma. — Dr. Crocker reports the following case : The patient was a girl of 13. The induration occupied nearly the whole body, and had begun to be hard only two weeks before. The face was swollen and the glands beneath the jaw were all enlarged. There was a fixed expression, and the face was pale. To the touch the skin was as hard as frozen fat ; did not pit on the firmest pressure ; and felt thickened and fixed to the subcutaneous tissues, so that it was impossible to pinch up a fold of skin. The palms, soles, and eyelids alone remained unaffected. In the mouth the mucous membrane of the right cheek vvas affected ; the mouth could be opened without pain, but the tongue was protruded with difficulty.
The induration of the skin was most marked on the flexor surfaces, the skin being shortened so that the limbs were bent, and on the forearms having the appearance and feel of cicatricial bands across the joints, preventing extension beyond a right angle. There was no pigmentation. Temperature, 101°; pulse, 116; respirations, 20. Lungs healthy; faint pericardiac friction and a mitral regurgitant murmur. A week later the pericarditis was more marked. Two weeks later pitting on pressure was noticed in the
