Flat Warts Research Articles

XERODERMA PIGMENTOSUM WITH MENTAL DEFICIENCY

Xeroderma pigmentosum is a comparatively rare disease which was first described by Kaposi. 1 It is of unknown etiology and probably congenital in origin. Consanguinity of the parents is said to be a predisposing factor. The onset of the disease occurs characteristically during the first year of life. The skin is apparently hypersensitive to light rays of wavelengths between 280 and 310 millimicrons. 2 The pathologic condition of the skin shows three stages: 3 (1) erythroderma, with mottling and hyperemia, slight puffiness and roughening, (2) pigmentation, with freckle formation, scaling and the formation of transient flat warts, and (3) the appearance of nonmetastasizing epitheliomas, cutaneous atrophy and late contractures of the eyelids, nose and mouth. The course is progressive but usually shows periods of quiescence. The duration of life is, as a rule, not beyond twenty-one years. Death generally results from inanition. Most of the cases of this condition have

VERRUCAE

Verruca vulgaris and verruca plana juvenilis are classified by Jadassohn1among the benign epitheliomas of infectious origin. The filiform wart of the face and scalp is closely related, and there is good evidence for classifying condyloma acuminatum in this group. The plantar wart is probably of the same etiology, although this relationship has not been demonstrated experimentally. Experiments by Ullman,2not yet repeated by other observers, suggest that the papilloma of the larynx of childhood may fall in the same group. The relationship between the various types has been demonstrated by the production of verruca vulgaris and verruca plana juvenilis from condyloma acuminatum and from filiform warts,3and by the production of verruca plana juvenilis from material derived from a laryngeal papilloma.2 Frey3adiscussed the relationship between warts and condyloma acuminatum. Two thirds of the patients with condyloma that he observed were free from syphilis,

DERMATOSIS PAPULOSA NIGRA (CASTELLANI) OF UNUSUAL DISTRIBUTION

Since Castellani's original communication, 1 cases have been reported by Castellani and Duval. 2 Michael and Seale 3 and myself. 4 Furthermore, many observers (Wise, 5 Fox, 6 MacKee 7 and others) have since recalled having seen similar cases previous to Castellani's report in 1925, which they, at that time, had diagnosed as flat warts, tiny nevi and a host of other clinical entities. Castellani 2 noted that numerous black or dark brownish papules, somewhat cupoliform or at times flattened, are seen on the face, principally on both malar regions ; while they are usually rare or absent on the lower parts of the face and chin, a few may be present on the forehead. Michael and Seale 3 enlarged this clinical concept and established, as a result of their microscopic studies, the nosologic position by showing that the lesion is a nevus, characterized histologically by an irregular, noninflammatory acanthosis

VERRUCAE VULGARES (PALMAR AND PLANTAR)

Numerous remedies have been employed in the treatment of common warts, ranging all the way from magic charms to surgical excision. Destruction by acids, electricity, carbon dioxide snow and radium, etc., have all produced good results in many cases. When large numbers of warts are present, however, local destructive measures are tedious, painful and, in the case of children, frequently difficult to carry out. Intramuscular injections of sulpharsphenamine have been used with success by some physicians, but the results are often disappointing, and the drug is not free from danger in such ailments as common warts. Since the administration of mercury by mouth is frequently beneficial in the treatment for juvenile flat warts, it was thought worth while to test the effect of another drug, bismuth, which in syphilis at least has a therapeutic effect similar to that of mercury. Previous experimental work has proved that warts are

LICHEN NITIDUS

Lichen nitidus is a comparatively rare disease which was first described by Pinkus 1 in 1901. He reported nine cases, all in men. The eruption consisted of flat-topped, shiny, pinkish papules which were neither confluent nor grouped, and which were most frequent on the genitalia, breasts, abdomen and arms, in the order named. Histologic examination showed a hemispherical granuloma in the upper cutis, composed of epithelioid and giant cells. The basal cell layer was lacking under the overlying epithelium. The papillae were horny and partly hyperkeratotic. No bacteria were found. The picture was that of an infectious granuloma. Pinkus stated that the differential diagnosis lay between verruca plana, lichen planus and lichen scrofulosus. The penis was involved in all of the twelve cases reported by Arndt 2 (Berlin), and in one case the mucous membrane also. He believed that the disease was of tuberculous origin. The animal inoculations in Kyrle's

THE TREATMENT OF FLAT WARTS BY THE INTERNAL ADMINISTRATION OF MERCURY

The suggestion of treating flat warts by the internal administration of mercury was first made by Dr. Charles J. White¹in 1915. This method of treatment was tried on the supposition that warts were caused by some as yet undiscovered protozoon. In his first paper White reported seven cases and four additional cases were reported in a subsequent communication. All of the eleven cases, except one, showed a most favorable response at the end of a few weeks to the internal use of some form of mercury. Four of White's patients were adults, the ages of the others varying from 7 to 14 years. In addition to the internal medication, some of the patients were also treated locally by salicylic acid or other remedy. The disease in question is often spoken of as verruca plana juvenilis, though it is by no means confined to juvenile patients. It generally appears

VERRUCA PLANA JUVENILIS

A case of verruca plana juvenilis is reported in detail in view of the multiple therapeutic aspects of this rather uncommon lesion. The condition is of importance when located on exposed areas, such as the face—where it occurs most frequently—and when the patient is a woman. This case is also important because of its bearing on Herxheimer and Marx' advice as to the use of arsenic and because it demonstrates a peculiar fact already mentioned by other authors, the cause of which is unknown, namely, the spontaneous disappearance of some warts when others, situated at a distance, disappear under treatment. CASE REPORT A young woman, aged 26 years, presented at a session of the Spanish Society of Dermatology and Syphilology last year because of some flat warts on the back of both hands and on the face, was treated with calcined magnesia during a short period, receiving 0.5 gm. a