Un texte américain-livre de maladies génito-urinaires, la syphilis et les maladies de la peau . de controverse. Dans la vue actuelle de la relation de 1 voie. Trans., xxxiv., 1883, p. 278 et 284. 2 Brit. Jnurn. Dermat., 1893. Une liste de tous les cas publiés est donné par Johnston, Journée.Cut. et le général-test urinaire. Dis., oct., 1895. 1000 de nouvelles excroissances. Les différentes formes de la maladie à l'autre palpebrarumand tuberosum xanthoma planum xanthoma multiplex sont considérées comme des processus identiques, whilemost auteurs conviennent à l'égard xanthoma diabeticorum comme une maladie distincte.La caractéristique de toutes les cellules de l'xa

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An American text-book of genito-urinary diseases, syphilis and diseases of the skin . controversy. In the current view of the relationship of 1 Path. Trans., xxxiv., 1883, pp. 278 and 284. 2 Brit. Jnurn. Dermat., 1893. A list of all the published cases is given by Johnston, Journ.Cut. and Gen.-urin. Dis., Oct., 1895. 1000 NEW GROWTHS. the various forms of the disease to each other xanthoma planum palpebrarumand xanthoma tuberosum multiplex are regarded as identical processes, whilemost authors agree in regarding xanthoma diabeticorum as a distinct disease.The characteristic cells of all the xanthomata are large, often multinuclearstructures, more or less filled with fine granular fat. Aggregations of thesecells occur in the corium, the epidermis showing virtually no changes; andconsiderable quantities of pigment, free in the lymph-spaces or enclosed incells, are scattered through the affected region. The yellow color of thepatches is probably due, however, to the fat rather than to the pigment. Asto the nature of the xanthoma cells there is great difference of opinion.. Fig 217.—Xanthoma planum palpebrarum vulgare : ep, epidermis; ft/, hair-follicle ; I, large xanthomacells; s, small xanthoma cells (authors case). Some authors look upon them as connective-tissue cells that have undergonefatty degeneration; some, as endothelial cells; some, as embryonically mis-placed fat-cells. For most authors the sole difference between xanthomadiabeticorum and the other xanthomata consists in the signs of more activeinflammation which the former shows. In my opinion, 1 the two forms ofgeneralized xanthoma are pathologically similar processes, and have no con-nection whatever with the localized form, the xanthoma planum palpe-brarum. I regard the generalized xanthomata as hyperplastic connective-tissue processes whose cells have a tendency to undergo fatty infiltrationwith ultimate degeneration. In the common multiple xanthoma the process1 The Nature of the Xanthomata, Journ. Cut

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