Archives of dermatology and syphilology Author:American Medical Association Purchase of this book includes free trial access to www.million-books.com where you can read more than a million books for free. This is an OCR edition with typos. Excerpt from book: ERYTHEMA NODOSUM SYPHILITICUM ERNEST L. McEWEN, M.D. CHICAGO The prime purpose of this paper is to direct the attention of dermatologists to a subject th... more »at has received scant consideration during the last fifteen years; a subject which seems to be not fully understood at the present time, and which is worthy of painstaking study, namely: the relation of syphilis to erythema nodosum. The scarcity of research contributions to the literature on this subject in recent years is due in part to the rare occurrence of the combination, and in part to a failure seemingly to appreciate the importance of the relationship. The latter attitude is entirely explicable. The term "erythema nodosum syphiliticum" implies that syphilis may be an independent cause of what is known clinically as erythema nodosum. Unfortunately the term has been applied loosely, without due consideration of its true meaning, to cases in which more than mere association was not proved; and this fact, together with the really great difficulty of determining a true causal relationship, has led many to doubt the validity of the whole conception. Nevertheless, since the fundamental papers on erythema nodosum syphiliticum were written the organism of syphilis has been discovered, the doctrine of focal infection has been elaborated, a better understanding of embolism and thrombosis as affecting the skin prevails, and the bacterial origin of simple erythema nodosum has been established. The subject therefore is ripe for investigation by every dermatologist; and those who have an abundance of derma- tologic and syphilitic material at their command are particularly fortunate in the opportunity before them. The puzzling elements in a case combining the features of erythema nodosum and syphilis are shown in the following ...« less