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THE PATHOGENESIS OF NONCASEATING TUBERCULOSIS OF THE SKIN AND LYMPH GLANDS

THE PATHOGENESIS OF NONCASEATING TUBERCULOSIS OF THE SKIN AND LYMPH GLANDS Abstract Recent observations of developments in the life history of the tubercle bacillus1 have afforded opportunity to reinterpret perhaps the traditional bacteriologic observations in noncaseating tuberculosis both in the skin and in the lymph nodes. The rather atypical clinical and pathologic features of conditions such as Boeck's sarcoid have always lacked any satisfactory explanation from the standpoint of pathogenesis. We shall present the clinical and clinicopathologic aspects of a human case and give an elaboration of the bacteriologic inquiry and its bearing on pathogenesis. REPORT OF A CASE J. J., a Negro aged 18, consulted us because of lesions on the forehead, cheeks, neck, arms, back, abdomen, thighs and legs. The patient made the statement that eight years previously he had sustained a fall which resulted in a laceration of his forehead; this when healed left a painless mass the size of a hazelnut at the site of injury. One References 1. Mellon, R. R., and Fisher, L. W.: New Studies on Filtrability of Pure Cultures of Tubercle Group of Micro-Organisms , J. Infect. Dis. 51:117, 1932.Crossref 2. Mellon, R. R.: The Newer Biology of the Tubercle Bacillus: Its Variability, Filtrability, and Life-Cycle Changes ; in Goldberg, B.: Clinical Tuberculosis , Philadelphia, F. A. Davis Company, 1935, chap. 2. 3. Mellon, R. R.; Richardson, Ruth D., and Fisher, L. W.: Further Studies on the Life Cycle of the Avian Tubercle Bacillus , Proc. Soc. Exper. Biol. & Med. 30:80, 1932. 4. Miller, Franklin: The Induced Development of Non-Acid-Fast Forms of Bacillus Tuberculosis and Other Mycobacteria , J. Exper. Med. 56:411, 1932. 5. Schaumann, J.: Benign Lymphogranuloma and Its Cutaneous Manifestations , Brit. J. Dermat. 36:515, 1924. 6. It is now well known that practically all bacteria exist in at least two phases: (1) a smooth colony (S), frequently virulent; and (2) rough colonies (R) of varying grades, which are likely to be avirulent or of lowered virulence. Yet, such associations of colony form and function are far from constant. In fact, the bacteriologic aspects of this study show that the S and R colony patterns not only are far from adequate to include the data here reported but are by no means constant as far as their virulence implications are concerned. Because these studies have such a pertinent bearing on the type of tuberculosis which we have to consider here, we have inserted the diagrammatic orientation of the cyclic relations of the tubercle bacillus in the paper referred to1c in addition to giving some of the high lights which have been developed since that time and are now in course of publication in extenso. Meanwhile, a fair perspective of its scope may be gained from a general review which we have made of the newer biology of the tubercle bacillus.1b 7. Kahn, Morton C., and Schwarzkopf, H.: Single-Cell Dissociation of Acid Fast Bacteria: Mycobacterium of Avian Tuberculosis; Mycobacterium of "Rat Leprosy ," J. Bact. 25:157, 1933. 8. Petroff, S. A., and Steenken, W.: Biological Studies of the Tubercle Bacillus: Instability of the Organism-Microbic Dissociation , J. Exper. Med. 51:831, 1930. 9. Crawford, Stanley: Cutaneous Nodulodiscoid Tuberculosis of Anergic Type, with Development into Active (Allergic) Pulmonary Tuberculosis , Arch. Dermat. & Syph. 27:766 ( (May) ) 1933. 10. Beaven, Paul: Personal communication to the authors. 11. Beaven, Paul, and Bayne-Jones, S.: Mycobacterium (Ryan Strain) Isolated from Pleural Exudate , J. Infect. Dis. 49:399, (1931) . 12. Metschnikoff, E.: Ueber die phagocytäre Rolle der Tuberkelxiessenzellen , Virchows arch. f. path. Anat. 113:63, 1888. 13. Coppen-Jones, A.: On the Morphology and Classification of the Tubercle Fungi-Form and Club-Form in Actinomycosis and Tuberculosis , Centralbl. f. Bakt. (Abt. 1) 17:70, 1895. 14. Karwacki, L.: Morphology of the Streptothrix Revealed by the Transformation of the Tubercle Bacillus , Compt. rend. Soc. de biol. 100:214 ( (Jan. 25) ) 1929. 15. Møllgaard, H.: Variation and Life Cycles , Beitr. z. Klin. d. Tuberk. 77: 83, 1931. 16. Mellon, R. R.: Studies in Microbic Heredity: VI. The Infective and Taxonomic Significance of a Newly Described Ascospore Stage for the Fungi of Blastomycosis , J. Bact. 11:229, 1926 17. Studies in Microbic Heredity: VII. The Genetic Origin of the Several Types of Fungi Found in the Lesions of Blastomycosis Hominis , Mellon J. Bact. 11:419, 1926 18. Kahn, M. C.: A Developmental Cycle of the Tubercle Bacillus as Revealed by Single-Cell Studies , Am. Rev. Tuberc. 20:150, 1929. 19. Kahn, M. C., and Nonidez, José F.: The Rôle of Non-Acid-Fast Rods and Granules in the Developmental Cycle of the Tubercle Bacillus , Am. Rev. Tuberc. 34:361, 1936. 20. Mellon, R. R.: Studies in Microbic Heredity: V. The Biogenetic Law of Haeckel and the Origin of Heterogeneity Within Pure Lines of Bacteria , J. Bact. 11:203, 1926. 21. McCarter, J., and Hastings, E. G.: The Morphology of the Mycobacteria , J. Bact. 29:503, 1935. 22. Oerskov, J.: A Morphological Study of the Initial Growth of the Tubercle Bacillus , Zentralbl. f. Bakt. (Abt. 1) 123:271, 1931 23. Further Remarks on the Morphological Studies on the Developmental Cycle of a Single Tubercle Bacillus , Oerskov Zentralbl. f. Bakt. 126:580, 1932 http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Dermatology and Syphilology American Medical Association

THE PATHOGENESIS OF NONCASEATING TUBERCULOSIS OF THE SKIN AND LYMPH GLANDS

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References (25)

Publisher
American Medical Association
Copyright
Copyright © 1937 American Medical Association. All Rights Reserved.
ISSN
0096-6029
DOI
10.1001/archderm.1937.01480030042004
Publisher site
See Article on Publisher Site

Abstract

Abstract Recent observations of developments in the life history of the tubercle bacillus1 have afforded opportunity to reinterpret perhaps the traditional bacteriologic observations in noncaseating tuberculosis both in the skin and in the lymph nodes. The rather atypical clinical and pathologic features of conditions such as Boeck's sarcoid have always lacked any satisfactory explanation from the standpoint of pathogenesis. We shall present the clinical and clinicopathologic aspects of a human case and give an elaboration of the bacteriologic inquiry and its bearing on pathogenesis. REPORT OF A CASE J. J., a Negro aged 18, consulted us because of lesions on the forehead, cheeks, neck, arms, back, abdomen, thighs and legs. The patient made the statement that eight years previously he had sustained a fall which resulted in a laceration of his forehead; this when healed left a painless mass the size of a hazelnut at the site of injury. One References 1. Mellon, R. R., and Fisher, L. W.: New Studies on Filtrability of Pure Cultures of Tubercle Group of Micro-Organisms , J. Infect. Dis. 51:117, 1932.Crossref 2. Mellon, R. R.: The Newer Biology of the Tubercle Bacillus: Its Variability, Filtrability, and Life-Cycle Changes ; in Goldberg, B.: Clinical Tuberculosis , Philadelphia, F. A. Davis Company, 1935, chap. 2. 3. Mellon, R. R.; Richardson, Ruth D., and Fisher, L. W.: Further Studies on the Life Cycle of the Avian Tubercle Bacillus , Proc. Soc. Exper. Biol. & Med. 30:80, 1932. 4. Miller, Franklin: The Induced Development of Non-Acid-Fast Forms of Bacillus Tuberculosis and Other Mycobacteria , J. Exper. Med. 56:411, 1932. 5. Schaumann, J.: Benign Lymphogranuloma and Its Cutaneous Manifestations , Brit. J. Dermat. 36:515, 1924. 6. It is now well known that practically all bacteria exist in at least two phases: (1) a smooth colony (S), frequently virulent; and (2) rough colonies (R) of varying grades, which are likely to be avirulent or of lowered virulence. Yet, such associations of colony form and function are far from constant. In fact, the bacteriologic aspects of this study show that the S and R colony patterns not only are far from adequate to include the data here reported but are by no means constant as far as their virulence implications are concerned. Because these studies have such a pertinent bearing on the type of tuberculosis which we have to consider here, we have inserted the diagrammatic orientation of the cyclic relations of the tubercle bacillus in the paper referred to1c in addition to giving some of the high lights which have been developed since that time and are now in course of publication in extenso. Meanwhile, a fair perspective of its scope may be gained from a general review which we have made of the newer biology of the tubercle bacillus.1b 7. Kahn, Morton C., and Schwarzkopf, H.: Single-Cell Dissociation of Acid Fast Bacteria: Mycobacterium of Avian Tuberculosis; Mycobacterium of "Rat Leprosy ," J. Bact. 25:157, 1933. 8. Petroff, S. A., and Steenken, W.: Biological Studies of the Tubercle Bacillus: Instability of the Organism-Microbic Dissociation , J. Exper. Med. 51:831, 1930. 9. Crawford, Stanley: Cutaneous Nodulodiscoid Tuberculosis of Anergic Type, with Development into Active (Allergic) Pulmonary Tuberculosis , Arch. Dermat. & Syph. 27:766 ( (May) ) 1933. 10. Beaven, Paul: Personal communication to the authors. 11. Beaven, Paul, and Bayne-Jones, S.: Mycobacterium (Ryan Strain) Isolated from Pleural Exudate , J. Infect. Dis. 49:399, (1931) . 12. Metschnikoff, E.: Ueber die phagocytäre Rolle der Tuberkelxiessenzellen , Virchows arch. f. path. Anat. 113:63, 1888. 13. Coppen-Jones, A.: On the Morphology and Classification of the Tubercle Fungi-Form and Club-Form in Actinomycosis and Tuberculosis , Centralbl. f. Bakt. (Abt. 1) 17:70, 1895. 14. Karwacki, L.: Morphology of the Streptothrix Revealed by the Transformation of the Tubercle Bacillus , Compt. rend. Soc. de biol. 100:214 ( (Jan. 25) ) 1929. 15. Møllgaard, H.: Variation and Life Cycles , Beitr. z. Klin. d. Tuberk. 77: 83, 1931. 16. Mellon, R. R.: Studies in Microbic Heredity: VI. The Infective and Taxonomic Significance of a Newly Described Ascospore Stage for the Fungi of Blastomycosis , J. Bact. 11:229, 1926 17. Studies in Microbic Heredity: VII. The Genetic Origin of the Several Types of Fungi Found in the Lesions of Blastomycosis Hominis , Mellon J. Bact. 11:419, 1926 18. Kahn, M. C.: A Developmental Cycle of the Tubercle Bacillus as Revealed by Single-Cell Studies , Am. Rev. Tuberc. 20:150, 1929. 19. Kahn, M. C., and Nonidez, José F.: The Rôle of Non-Acid-Fast Rods and Granules in the Developmental Cycle of the Tubercle Bacillus , Am. Rev. Tuberc. 34:361, 1936. 20. Mellon, R. R.: Studies in Microbic Heredity: V. The Biogenetic Law of Haeckel and the Origin of Heterogeneity Within Pure Lines of Bacteria , J. Bact. 11:203, 1926. 21. McCarter, J., and Hastings, E. G.: The Morphology of the Mycobacteria , J. Bact. 29:503, 1935. 22. Oerskov, J.: A Morphological Study of the Initial Growth of the Tubercle Bacillus , Zentralbl. f. Bakt. (Abt. 1) 123:271, 1931 23. Further Remarks on the Morphological Studies on the Developmental Cycle of a Single Tubercle Bacillus , Oerskov Zentralbl. f. Bakt. 126:580, 1932

Journal

Archives of Dermatology and SyphilologyAmerican Medical Association

Published: Sep 1, 1937

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