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