The increasing popularity of mah jongg has brought to my attention a number of cases of dermatitis of the hands and face in which I have suspected that the irritating agent was the Japanese lacquer with which the mah jongg sets are varnished. In the subjoined case this was definitely proved to be the etiologic factor. REPORT
Tuberculosis in the buccal cavity presents itself in almost as many diverse forms as on the integument, and frequently gives rise to diagnostic errors. The subject is given scant consideration in textbooks on dermatology, usually under the heading of tuberculosis cutis orificialis, and in books on general medicine it is considered briefly in relation to respiratory tuberculosis. Special treatises on diseases of the mouth, such as that of Mikulicz and K\l=u"\mmell,1 recognize these types of oral tuberculosis: (1) lupus of the mucous membranes; (2) tuberculosis ulcerations, rhagades and infiltrates of the tongue and lip; (3) isolated ulcers of the soft palate; (4) miliary ulcerations occurring at the corners of the mouth, on the lip and edges of the tongue in advanced cases of phthisis. Jadassohn,2 in his masterly review of the subject of tuberculosis of the skin and mucous membranes, divides this into : (1) lupus of the mucous membranes ; (2) miliary ulcerations involving the mucous membranes and adjacent skin ; (3) tuberculous ulcers of nonmiliary character involving the lip, tongue and genital regions. Osier3 states that tuberculosis of the lip is extremely rare even in cases of advanced pulmonary disease. Con¬ sidering the frequency with which tubercle bacilli in the sputum come in contact with the lips, it seems unusual that they should be so seldom affected. An internist who sees large numbers of pulmonary cases recently stated that he had never seen an involvement of the lip in more than 20,000 patients with tuberculosis examined by him. In view of these facts, the subjoined case seems of sufficient interest to warrant a detailed report.
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