Epithelioma is a disease of advanced life and often develops from an irritation of warts, moles and similar growths. It is painful and while limited to a smaller area, its progress is frequently more rapid and the glands more involved. A skin cancer may originate in a chronic lupus patch, hence the two diseases may coexist. The smooth floor and indurated border of the rodent ulcer, typical of epithelioma, is a distinct point in differentiation.
Lupus erythematosus usually appears after puberty, is symmetrical in distribution, is superficial in nature, without soft nodules or tendency to suppurate. If the adherent crusts are removed, the widened opening of one or more sebaceous ducts will be revealed corresponding to little projections on the under surface of the crust.
Squamous eczema and dermatitis seborrhoica will invariably show some exudation with a tendency to itching but lack the apple-jelly nodules, persistent course or tendency to scar formation.
The early stage of tubercular or mixed leprosy presents a more generalized eruption, usually begins later in life and has anesthetic, macular patches.
Prognosis. – Lupus is always a chronic disease, rebellious to treatment and, though it does not thrive in this country as elsewhere and is less virulent and progressive with us, there is always the danger of relapses. It seldom destroys life and though the danger of secondary tubercular infection is possible, it is not great. Scarring is to be expected in all cases. The prospects of a cure depend upon the age of the subject, the duration and extent of the disease, and the persistent cooperation of the patient. Relatively the prognosis is good as compared with tuberculosis of other organs.
American homeopath, he directed several hospitals in New York.
Professor of dermatology.
Served as Lieut. Colonel during the 1st World War.
See his book online: American homeopathy in the world war