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Updated: June 28, 2025
The tongue often presents a combination of lesions, including ulcers, patches where the papillæ are absent, fissures, and raised white papules resembling warts, especially towards the centre of the dorsum. These lesions are specially apt to occur in those who smoke, drink undiluted alcohol or spirits, or eat hot condiments to excess, or who have irregular, sharp-cornered teeth.
With undermining it is usually easy to bring the edges of the gap in the abdominal wall together, even in children; the skin flap on the dorsum of the hand appears rather thick and prominent almost like the pad of a boxing-glove for some time, but the restoration of function in the capacity to flex the fingers is gratifying in the extreme.
The tarsal ganglion is situated on the dorsum of the foot over one or other of the intertarsal joints. It is usually smaller, flatter, and more tense than that met with over the wrist, so that it is sometimes mistaken for a bony tumour. It rarely causes symptoms, unless so situated as to be pressed upon by the boot.
When gangrene occurs from such causes, it tends to be of the moist type. Much commoner is it to meet with localised areas of necrosis due to the excessive pressure of splints over bony prominences, such as the lateral malleolus, the medial condyle of the humerus, or femur, or over the dorsum of the foot.
It may cause no symptoms or it may interfere with the use of the hand, especially in grasping movements and when the hand is dorsiflexed. In girls it may give rise to pain which shoots up the arm. Ganglia are also met with on the dorsum of the metacarpus and on the palmar aspect of the wrist. [Illustration: FIG.
The soft parts, including the nail, should be reflected towards the dorsum in the form of a flap, the base of the exostosis divided with the chisel, and the exostosis removed. Malignant disease in relation to the nails is rare. Squamous epithelioma and melanotic cancer are the forms met with. Treatment consists in amputating the digit concerned, and in removing the associated lymph glands.
In some cases both connective tissue planes are involved. The affected finger becomes red, painful, and swollen, the swelling spreading to the dorsum. The involvement of the tendon sheath is usually indicated by the patient being unable to flex the finger, and by the pain being increased when he attempts to do so.
While they are commonest on the sole of the foot and other parts subjected to pressure, perforating ulcers are met with on the sides and dorsum of the foot and toes, on the hands, and on other parts where no pressure has been exerted.
Imbert-Gourbeyre that she bled in the shape of the cross, and he gives a wood-cut representing a cross on the dorsum of the hand, a little above the space between the first and second fingers. This is surrounded by other rectilinear figures. On her breast and back, other figures were obtained by placing handkerchiefs on the parts.
In concealed chancres with phimosis, the sac of the prepuce should be slit up along the dorsum to admit of the ointment being applied. If phagedæna occurs, the prepuce must be slit open along the dorsum, or if sloughing, cut away, and the patient should have frequent sitz baths of weak sublimate lotion.
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