Page:Archives of dermatology, vol 6.djvu/447

 AMERICAN DERMATOLOGICAL ASSOCIATION. 435

seen a case of cancer of the prepuce in a boy seven years of age. The principles laid down in the paper were of general application, and the majority of cases conform to them.

Dr. W. a. Hardaway, of St. Louis, read a paper on

Papilloma cutis.*

Dr. Heitzmann, of New York, considered the paper interesting and instructive, but if the term papilloma was strictly applied, it would certainly exclude some of the cases reported. One of the forms referred to as malignant papilloma the speaker would rather consider as cancer with a papillomatous appearance, and he would object to the former term, which must be avoided in order to keep in accord with modern ideas of pathology of these morbid growths. He thought that this mixed nomenclature should be entirely aban- doned ; such a case is either papilloma or it may be a cancer with papillary appearances upon its surface. Sometimes the tendency of a malignant growth is to extend deeper than is usual and affect particularly the appendages, forming what is frequently called cauli- flower cancer; such a growth, however, could not properly be in- cluded among papillomata.

Dr. Bulklev, of New York, said that he had encountered two con- ditions which he had found difficult to classify except among the papillomatous formations. In the cases he had seen they had oc- curred in elderly persons, and chiefly about the hands. Two distinct conditions are recognized in the two following cases. An elderly man presented a red and horny patch upon the back of his hand, asso- ciated with considerable amount of thickening and elevation, so that the integument appeared to be several times its normal thickness. The patch gave rise to no secretion, save that it occasionally became bloody from accidental abrasion ; there was no excoriation. The other form, also seen in elderly people, is very soft and bleeds readily. In one case an old woman struck her hand against a piece of stone or coal ; the dorsum of the hand at the part injured grad- ually exhibited a form of papillomatous growth soft in character but not moist, leaving a tolerably good cicatrix at one part, but at the margin near the wrist it was slowly spreading. It was persistent, lasting at least four years, and probably longer. In this case the papillary formations were very long comparatively; raised on a probe they were seen to be about one-third of an inch in length and pointed at the end ; lifting them up in this manner often pro- duced oozing of blood, and subsequently some pus and crusting, causing annoyance to the patient. The color was not nearly so red as in the former case. He had taken a portion of the skin from the first patient, but was not yet prepared to report upon it. With re- gard to the soft variety he could not exactly decide upon its patho-
 * See page 387.