Esthiomène, or Lupus Vulvæ. A historical pathological, and clinical study, with analysis of six cases from the General Hospital, Birmingham, and ten micro‐photographs.

Abstract

Esthiombne, or Lupus Vulvae. A historical pathological, and clinical study, with analysis of six cases from the General Hospital, Birmingham, and ten micro-photographs. By LBXA KURZ, M.D. IN the year 1849 Huguier published his remarkable essay entitled, " D e 1'Esthiombne de la Vulve et du Perinee." He derived the name from the Greek word 'E&w which signifies tg eat away. Previous to the appearance of this essay every variety of vulvar ulceration had been described under the name of " lupus," irrespective of the cause and nature of the ulceration. After the publication of Huguier's essay the term esthiomhne was adopted by numerous French and English authors, many of whom retained the term lupus concurrently. It is obvious that numerous authors understood by both terms merely a process of ulcerative destruction and did not intend to point to any definite causation by the choice of name. TERMINOLOGY. Esthiombne has been frequently described under the term lupus to which all varieties of descriptive adjectives have been appended, such as lupus hyperphicus, serpiginosus, prominens, perforans, etc. According to the main features presented by the case described the term lupus did not imply tuberculosis. Another name frequently met with is herpes-herpes excedens and sometimes " herpes esthiomhne." Among Clerman authors the condition was most frequently described as "ulcus." Virchow called it " ulcus rodens vulvse," while F. Koch used the term " ulcus chronicum elephantiasticum," Recent authors, both Continental and British, have published their cases under such terms as "lupoid ulcer," This large variety of names used in describing esthiombne points to two facts; firstly, that the writers did not describe one special type of perineal ulceration with hypertrophy, but all and every kind of ulcerative process met with in the vulvo-anal region; secondly, that genito-anal scleroma " and " esthiomic ulcer." 6 6 24 ' I System of Gynaecology." " Diseases of Women," 1907. 1884.