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Rh slow. Ulceration rarely occurs, but the centre of the patch may undergo a spontaneous cure, leaving cicatricial tissue.

Still another form of cutaneous tuberculosis is that commonly described under the name of scrofuloderma. This appears in the form of suppurating or crusted ulcers of the skin in children who usually present other evidences of the scrofulous taint. It is most frequently observed upon the neck over

. 40.—Lupus verrucosus (tuberculosis verrucosa cutis).

lymphatic glands which have undergone caseous degeneration and softening, although it may occur in multiple discoid lesions over the buttocks, thighs, and other portions of the body. When lupus or scrofuloderma attacks the hand or fingers of a child the bony tissue is frequently involved and a strumous dactylitis may develop, or caries with resulting atrophy and a considerable subsequent deformity (Fig. 41).