Two cases of acute general psoriasis following vaccination / by George H. Rohé.

  • Rohé, George H. (George Henry), 1851-1899.
Date:
[1882]
Catalogue details

Licence: Public Domain Mark

Credit: Two cases of acute general psoriasis following vaccination / by George H. Rohé. Source: Wellcome Collection.

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    ■was brought to my clinic at the City Hospital, April 17th, 1882. The boy was generally in good health, and neither he nor his parents had ever before suffered from any skin eruption. He had been vaccinated by one of the official vaccine physicians of the city a month before. The vac¬ cination was successful. Bovine virus had been used. After the crust had fallen off, the spot became scaly and larger. Then small scaly spots -appeared all over the body, and led to his being brought to the clinic. My notes made at the time state that a psoriatic eruption in points and spots is disseminated over the entire body, being thickest on the lum¬ bar region. The elbows are the seats of large red patches, thickly covered with white scales. There is also a patch as large as a dime upon the left cheek, and a number of smaller spots scattered over the scalp. The patient appears otherwise in good health, and does not complain of much itching. He was placed on three drops of Fowler’s solution thrice daily, and the following ointment, directed to be applied locally, after a thorough scrubbing with soap and water to remove the scales: B Hydrarg. ammoniat.3 i. Bismuthi subnitr. 3 ss. Ungt. petrolei. § i. M. ft. ungt. Two months later, the eruption had entirely disappeared, but, when I last examined the patient, about the middle of July, I found several small scaly papules, indicating a return of the affection. The rapid development of the eruption, and the excessive itching present in the first case reported above, caused me to hesitate in my diagnosis, but, after watching the case for a few days, there remained no further room for doubting that the case was one of psoriasis. In the second case, the diagnosis was clear from the beginning. I entirely agree with the opinion so strongly upheld by Hebra and the Vienna school, that an eruption of psoriasis may be produced by any irritant applied to a skin predisposed to take on this disease, but the ab¬ sence of cases in the literature, depending upon vaccination as an exciting nause, has induced me to report the above cases. DISCUSSION. Dr. Heitzmann said that this paper was clear, conclusive, logical; •and especially the last statement, that in a psoriatic subject any irrita¬ tion may produce psoriasis. The writer did not claim that there is any direct connection between vaccination and psoriasis; and it does not need discussion. Dr. Hardaway said that he had not seen any such occurrence of psoriasis after vaccination, although he had had considerable experience with vaccination. There are a number of eruptions which may occur— herpes, erythema multiforme, and eczema are often met with. There are three stages of development at which a vaccination eruption may appear: The first is during the period of irritation from the wound made by the lancet, which may cause acute local inflammatory trouble, or erysipelas;