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Finally, a long-standing lupus, especially on the cheek, may become the seat of epithelioma lupus epithelioma usually of the exuberant or cauliflower type, which, like other epitheliomas that originate in scar tissue, presents little tendency to infect the lymphatics.
Epithelioma may develop anywhere on the body in relation to long-standing ulcers, especially that resulting from a burn or from lupus; this form usually presents an exuberant outgrowth of epidermis not unlike a cauliflower. An interesting example of epithelioma has been described by Neve of Kashmir.
As a result of injury the cyst may undergo sudden enlargement from hæmorrhage into its interior. Recurrent attacks of inflammation frequently occur, especially in wens of the face and scalp. Suppuration may ensue and be followed by cure of the cyst, or an offensive fungating ulcer forms which may be mistaken for epithelioma. True cancerous transformation is rare.
The second type is met with in relation to epithelioma occurring in a sinus, the sequel of suppurative osteomyelitis, compound fracture, or tuberculous disease. The patient has usually had a discharging sinus for a great number of years: we have known it to last as many as fifty.
In a second case in which the growth was in the groin, the patient, a young man, remained well for over two years and was then lost sight of. #Secondary Tumours.# Next to tuberculosis, secondary cancer is the most common disease of lymph glands. In the neck it is met with in association with epithelioma of the lip, tongue, or fauces.
In the same group are three or four glands which lie entirely under cover of the upper end of the sterno-mastoid muscle, and surround the accessory nerve before it perforates the muscle. The deep cervical glands are commonly infected by tubercle and also by epithelioma secondary to disease in the tongue or throat.
They receive lymph from the face, lips, floor of the mouth, gums, teeth, anterior part of tongue, and the alæ nasi, and from the pre-auricular glands. The lymph passes from them into the deeper cervical glands. They are frequently infected with tubercle, with epithelioma which has spread to them from the mouth, and also with pyogenic organisms.
Also he remembered casually an official letter received from Troy, a couple of days ago, concerning one Nicholas Nanjivell, a reservist. The man, if he remembered rightly, had an epithelioma somewhere in his leg, and was quite unfit for service. Nevertheless he must be visited: for the letter was official.
It is recognised clinically by the characteristic cauliflower growth at the orifice of the sinus, and by the offensive nature of the discharge. A similar epithelioma may arise in connection with a chronic ulcer of the leg. The cancer may infect the femoral lymph glands.
Structure of skin Blisters Callosities Corns Chilblains Boils Carbuncle Abscess Veldt sores Tuberculosis of skin: Inoculation tubercle Lupus: Varieties Sporotrichosis Elephantiasis Sebaceous cysts or wens Moles Horns New growths: Fibroma; Papilloma; Adenoma; Epithelioma; Rodent cancer; Melanotic cancer; Sarcoma AFFECTIONS OF CICATRICES Varieties of scars Keloid Tumours AFFECTIONS OF NAILS.
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