PEMPHIGUS.
Definition.—This is a comparatively rare skin affection characterized by the formation of blebs, or bullm, containing a serous or sero-purulent fluid, and often attended by constitutional disorders.
Varieties. — Three main varieties of pemphigns are recognized: (1) pemphi gas rulgaris, which may be acute or chronic and usually terminates fatally; (2) pemphigus foliareus, a malignant form, in which the bulhe are purulent from the start, rapidly increase, do not heal, and are replaced by lamellre, or scales; and (3) pemphigus neonatorum, an acute infectious form observed in infants at birth or soon after birth and usually ending in recovery.
Symptoms.—PEMPHIG US VULGA It IS.— There usually appear a few discrete bulls: about the face which gradually invade the entire body, but especially the trunk and upper extremities. The bullT con tain a serous liquid which in some cases becomes purulent and haamorrhagic. Itching and burning are experienced, accompanied by slight prostration, ano rexia, and, occasionally, slight fever. The disease remains stationary some weeks, and then suddenly assumes a state of exacerbation, during which more India: are developed or older ones become greatly increased in size, and confluent.
Successive attacks occur, weeks or months apart, each being attended by sharper manifestations, local and general. The oral cavity, the eyes, the genitalia, and the respiratory and gastrointestinal tracts are gradually invaded, and the patient sinks into a cachcctic condition from which he does not rally. This con what is often termed the chronic, or slow, form.
In the acute form the symptoms out lined merely occur in closer succession and are grave from the start, chills, high fever, delirium, albuminuria, etc., follow ing in rapid succession. The eruption, however, is usually limited to the upper part of the body and is discrete (Bazin). Death occurs in from ten clays to two weeks after the onset. It greatly resem bles a contagious form, which, however, is much more rare.