ANOMALOUS this head ing may be included forms mentioned by Duhring as occurring in the course of asthma, rheumatism, gout, liemiplegia, chorea, epilepsy, exophthalmic goitre, and other toxic influences.
Erythematous and erythemato-papular eruptions observed in the course of blen norrhagia resemble those found in other infectious diseases, as pyainia, etc. Dubreuilh (Annales de la Polyclin. de Bordeaux, July, '89).
Man, 20 years old, with decided neu rotic tendencies, who, during convales cence, displayed a polymorphous ery thema. Peter (La Semaine Med., July 15, '9I).
Case of a man admitted to the hospital for unilateral rheumatism of the ankle and knee-joint. The following night an eruption suddenly manifested itself on the flexor and extensor surfaces of the arms, on the face, back, chest, and palms, but not on the backs of the hands. The patches were erythematous, pea-sized, ill-defined, and very numerous, and were itchy from the beginning. The eruption continued to spread over the general sur face, and four days later attacked the mucous membrane of the pharynx. The rheumatic pains subsided after the efflo rescence began to appear. General des quamation set in two weeks after the first appearance of the eruption, having been preceded by a change in the char acter of the lesions, the characteristic patches of erythema mu ltiforme giving way to a generalized eruption of numer ous minute, yellowish-gray, superficial vesicles, such as are met with in scar latina. Large, exfoliative patches of skin were thrown off, with glove-like casts of the hands and feet, similar to the exfoliation of dermatitis exfoliativa. The duration of the whole disorder was about three Nveeks. Duhring (Jour. of Cut. and Genito-Urin. Dis., Nov., '91).
A large proportion of the cases of ery thema multiforme are associated with rheumatism, and can only be looked upon as results of the rheumatic poison. Stephen Mackenzie (Practitioner, Nov., '90).
This variety also includes the form observed during variola. It may be no ticed about the second day of small-pox, and before the appearance of the specific eruption. According to Atkinson, of
Baltimore, it generally spares the por tions generally invaded by small-pox and rarely lasts more than twenty-four hours. The character of erythema observed is a diffuse redness, of a violaceous color, and in size varies from a pin-head to a lima bean.
Erythema vaccininni occurs during the course of vaccination. It may appear early, during the first two days, or may be delayed until the sixth or seventh, or at the time of beginning ulceration. Many patches of macules may be found over the body-surface, with here and there an isolated macule of a bright-red color.
But 2 cases of purpura and 14 cases of erythema in the course of 430 vaccina tions. The erythema resembled the ex anthem of measles. It developed in the course of from 24 to 72 hours, and per sisted ordinarily for from 6 to S days. Epstein (Jahrbuch f. Kinderh. u. phy sische Erzielmng, II. 35, p. 442, '93).
Erythema diphtheriticum, is the form of disease observed in connection with diphtheria, in both mild and severe cases. (See DIPHTHERIA.) It appears some times as late as the second or third clay of the diphtheritic process, and may oc cupy the trunk or extremities only, or may cover the greater portion of the body. The lesions are a diffuse redness of a mottled, punctate, or scarlatinal form, and when in patches it is generally located upon the thorax and abdomen, though frequently upon the extremities. According to A. R. Robinson, it does not usually increase in size after the first few hours and disappears during the next twenty-four or forty-eight hours without leaving any desquamation.
_Erythema Choleraicunz.—According to Duhring, there is an erythematous erup tion observed in cholera patients. It occurs in polymorphous manifestations. These are usually macular, maculo-papu lar, or papular, and are noted upon the dorsal surfaces of both the hands and feet, forearms, legs, face, and trunk. It may appear either at the beginning or termination of the disease and disap pears in the form of a desquamation.