Lupus

Lupus (Lat. lupus, wolf), a disease characterized by the formation in the skin or mucous membrane of small tubercles or nodules consisting of cell growth which has an inclination to retrograde change, leading to ulceration and destruction of the tissues, and, if it heals, to the subsequent formation of permanent white scars. Lupus vulgaris is most commonly seen in early life, and occurs chiefly on the face, about the nose, cheeks or ears. But it may also affect the body or limbs. It first shows itself as small, slightly prominent, nodules covered with thin crusts or scabs. These may be absorbed and removed at one point whilst spreading at another. Their disappearance is followed by a permanent white cicatrix. The disease may be superficial, in which case both the ulceration and the resulting scar are slight (lupus non-exedens); or the ulcerative process may be deep and extensive, destroying a large portion of the nose or cheek, and leaving much disfigurement (lupus exedens). A milder form, lupus erythematosus, occurs on the nose and adjacent portions of the cheeks in the form of red patches covered with thin scales, underneath which are seen the widened openings of the sebaceous ducts. With a longitudinal patch on the nose and spreading symmetrical patches on each cheek the appearance is usually that of a large butterfly. It is slow in disappearing, but does not leave a scar. Lupus is more frequently seen in women than in men; it is connected with a tuberculous constitution. In the superficial variety the application of soothing ointments when there is much redness, and linear incisions, or scrapings with a sharp spoon, to destroy the increased blood supply, are often serviceable. In the ordinary form the local treatment is to remove the new tissue growth by solid points of caustic thrust into the tubercles to break them up, or by scraping with a sharp spoon. The light-treatment has been successfully applied in recent years. As medicines, cod-liver oil, iron and arsenic are useful.

(E. O.*)