Case of eczema following the course of the small sciatic and short saphenous nerves.

Shearar, Frank.

Journal : Glasgow Medical Journal ; vol. xxiii.

Glasgow : Alex. MacDougall ;
London : H. K. Lewis, 1885.

Description : [1 l.] pl., 81-84 p. ; ill.: 1 phot. ; 22 cm.

Photograph : hind lower extremities of the clinical subject.

Subject : Sciatic and saphenous nerves — Eczematous infections.

Notes :

This eruption, a photograph of which is appended, is a very interesting one, because of its exceptional character, its evident neurotic origin, and its lengthened duration. It is essentially eczematous in its nature; it extends, as a continuous ribbon-shaped band, from the left buttock to the base of the little toe; it corresponds, to a considerable extent, with the courses of the small sciatic and short saphenous nerves; it has been in existence, in part at least, for nearly eighteen months; it began without any apparent cause, and it has not been associated at any time with neuralgic pains, or with any alteration in sensation. — Page 81.

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A remarkable and idiopathic case of an eczematous skin infection in a 13 year-old boy, coursing along the trunks of his small sciatic and short saphenous nerves like the path left by a burning fuse. The case made Dr. Shearar a celebrity and entered his name into a great number of leading medical journals including the 1895 issue of International Atlas of Rare Skin Diseases. An update appeared in volume xxxi of the GMJ (1889) where Shearar reported that Drs. M'Call Anderson and Allan Jamieson examined the boy — then a 17 year-old — and both men thought the lesions might be scrofuloderma. Henry Radcliffe-Crocker also expressed doubt that it was eczema. The child was also examined and photographed by Dr. Unna at his Hamburg Polyklinik for skin diseases. Unna improvised the term, granuloma pantitrinum or panther granuloma as a diagnosis. The image is one of the more stunning in the medical photography canon — a stroke of nature recorded by an instrument of nature.

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