PRIMARY LESIONS OF PEMPHIGUS VULGARIS

Abstract
The question whether, like syphilis, pemphigus vulgaris begins with a primary lesion some time prior to the generalized eruption has been discussed by several authorities since Neumann,1chief and teacher of Oppenheim and assistant to Hebra, described in his textbook the first case of pemphigus vegetans, observed in 1874. A diagnosis of syphilis cutanea vegetans was made but was later corrected (1886). In the right axilla there were separate blisters which showed no tendency to become epidermized, and there was a dark red elevated area the size of a dollar denuded of epidermis. Leszczynski2gives a similar description of a primary lesion of pemphigus vulgaris. In his case a few blisters appeared a short time later on the lower lip and on the oral mucous membrane. Three months afterward a generalized rash of blisters appeared, with vegetations on the labia majora and in the groinsand axillas, and finally

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