|
|
McCall Anderson's Classification of Skin Diseases
 Reproduced
below are the contents of pages 8-12 of Thomas McCall Anderson's "Treatise
on Diseases of the Skin, with Special Reference to their Diagnosis and Treatment" (London:
Charles Griffin and Company, 1887). In addition to accounts of individual disorders,
this textbook includes a tabulation by diagnosis of 11,000 consecutive cases
of skin disease. This early "diagnostic index" reflects both the
skin diseases prevalent and the social conditions in Glasgow at the time.
The Classification of Diseases of the Skin
It is not my intention to dwell at any length upon the classification
which I have adopted, and which is but a modification of that followed
for many years at the Glasgow Hospital for Skin Diseases, as explained
by the late Dr. A. B. Buchanan in a very able article which he communicated
to the Edinburgh Medical Journal, January, 1863. The object aimed at
in this classification was to render it as useful as possible from a
clinical point of view, and hence the most important point was to arrange
the various diseases, as far as practicable, in accordance with their
nature and cause. It is most desirable, no doubt, to have a classification
in accordance with one principle; but in the present state of our knowledge
it is impossible to fulfil the latter indication except at the expense
of the former; and, accordingly two principles are involved in this clinical
classification - namely, the pathological and the etiological.
We divide skin diseases, then, into two great classes - namely, (a)
Functional and (b) Organic.
The Functional we subdivide into -
- Affections of the skin.
- Affections of the hair.
- Affections of the sebaceous glands
- Affections of the sudoriparous glands.
|
The Organic we subdivide into-
- Inflammations.
- New formations and tumours
- Haemorrhages.
- Diseases produced by uniform causes.
- Parasitic affections.
- Syphilitic affections.
- Strumous affections
- Eruptive fevers.
|
Before entering upon the consideration of the individual diseases of
the skin, one or two preliminary observations may be made. The first
of these is that it is always desirable, when possible, to examine our
patients by daylight, especially in cases of doubt or difficulty, for
artificial light alters the colouring, and changes the appearances of
many eruptions to an extent that could hardly be credited. Again, it
is of importance to make a rule of examining the whole surface of the
body, or as much of it as possible, so as to enable us to secure a good
general picture of the disease, and this is all the more necessary, seeing
that the patient has a, tendency to exhibit the part most readily uncovered,
or which he has least delicacy in exposing, or where the eruption appears
to him to have assumed the most aggravated form. Now, it happens not
infrequently that such a part is least characteristic of the disease,
of which we have frequent illustrations in cases of scabies. Here, for
example, the patient may exhibit his leg, which, as the result of scratching,
is the seat of an acute eczematous affection, and, if we were to limit
our view in such a case to this part, we would be apt to commit the error
of calling the disease Eczema instead of Scabies. Finally, we must not
at once accept as correct the statement of the patient as to the limitation
of the eruption to the part exposed. Many say so in order to save themselves
trouble, or from a. false feeling of delicacy, or because they are really
ignorant, or forgetful, of the existence of any eruption elsewhere.
ANALYSIS OF 10,000 CONSECUTIVE CASES OF SKIN
DISEASE MET WITH IN HOSPITAL PRACTICE
Functional Affections |
Pruritus
Seborrhoea
Comedones
Milium
Hyperidrosis
Ephelis
Melanopathia
|
39
13
10
1
5
3
1 |
|
Vitiligo
Atrophia cutis
Alopecia
Alopecia areata
Hirsutes
Fragilitas crinium |
4
2
56
153
2
3 |
Organic Affections |
I. Inflammations |
Erythema *
Erythema multiforme
Erythema nodosum
Erythema pernio
Eczema †
Impetigo contagiosa
Ecthyma ‡
Prurigo
Urticaria #
Zona [= zoster]
Dermatitis |
470
1
5
2
2527
10
97
1
147
32
27 |
|
Erysipelas †
Acne vulgaris
Rosacea
Psoriasis §
Pemphigus
Pemphigus foliaceous
Pityriasis rubra
Deep inflammations
Ulcers ¶
Onychia |
10
288
37
725
12
1
6
345
433
10 |
* Including strophulus,
pityriasis and roseola
† Including its lichenous and impetiginous forms
‡ Including rupia non-syphilitica
|
|
# Including lichen urticatus
§ Including Lepra
¶ Independent of struma and syphilis |
II. New Formations |
Varix
(uncomplicated)
Naevus vascularis
Naevus spilus
Verruca
Callositas
Clavus
Cornu
Ichthyosis
Scleroderma
Elephantiasis Arabum
|
41
9
2
29
10
1
2
31
1
7 |
|
Elephantiasis Graecorum
[= leprosy]
Molluscum contagiosum
Fibroma molluscum
Cicatrix
Cheloid
Scirrhus
Epithelioma
Unclassified tumours |
1
6
1
4
5
5
38
2 |
III. Haemorrhages |
Purpura simplex
Purpura tuberculosa
Purpura rheumatica |
6
1
1 |
IV. Disorders produced
by uniform causes |
a. Parasitic Affections |
Vegetable |
Tinea favosa
Tinea trichophytosa:
Tinea versicolor |
Circinata
Tonsurans
Circinata et tonsurans
Sycosis
|
156
4
67
3
18
106 |
Animal |
Scabies
Phtheriasis [= lice] |
2527
327 |
b. Syphilitic affections |
|
Primary accidents
Secondary accidents
Hereditary syphilis (infantile)
Hereditary syphilis (non-infantile) |
24
437
55
1 |
c. Strumous [=tuberculous]
affections |
Lupus
Scrophuloderma
Lichen scrophulosorum |
198
27
3 |
|
Strumous glands
Strumous ulcers
Strumous abscesses |
191
85
8 |
d. Eruptive fevers |
|
Morbilli
Scarlatina
Variola |
1
2
6 |
|
|
ANALYSIS OF 1,000 CONSECUTIVE CASES OF SKIN
DISEASE MET WITH IN PRIVATE PRACTICE
Functional Affections |
Pruritus
Comedones
Hyperidrosis
Ephelis
Atrophia cutis
|
11
7
1
3
1 |
|
Alopecia
Alopecia areata
Hirsutes
Fragilitas crinium
Canities |
18
44
5
2
4 |
Organic Affections |
I. Inflammations |
Erythema *
Erythema pernio
Eczema †
Impetigo contagiosa
Prurigo
Urticaria
Zona [= zoster]
Acne vulgaris
|
99
2
348
1
2
5
1
54 |
|
Rosacea
Psoriasis §
Pemphigus
Pityriasis rubra
Lichen ruber
Furunculus
Ulcers ¶ |
21
106
3
1
1
17
7 |
* Including strophulus,
pityriasis and roseola
† Including its lichenous and impetiginous forms |
|
§ Including Lepra
¶ Independent of struma and syphilis |
II. New Formations |
Varix
(uncomplicated)
Naevus vascularis
Naevus spilus
Verruca
Ichthyosis
Scleroderma
|
4
2
1
4
7
1 |
|
Elephantiasis Arabum
Elephantiasis Graecorum
[= leprosy]
Scirrhus
Epithelioma
Multiple tumours |
1
1
2
9
1 |
III. Haemorrhages |
Purpura rheumatica
Haemidrosis |
1
1 |
IV. Disorders
produced by uniform causes |
a. Parasitic Affections |
Vegetable |
Tinea favosa
Tinea tricophytosa:
Tinea versicolor |
Circinata *
Tonsurans
Sycosis
|
4
10
20
6
15 |
|
* Including the so-called Eczema marginatum
|
Animal |
Scabies
Phtheriasis [= lice] |
44
7 |
b. Syphilitic affections |
|
Secondary and tertiary accidents
Hereditary syphilis (infantile)
Hereditary syphilis (non-infantile) |
51
3
3 |
c. Strumous [=tuberculous]
affections |
Lupus vulgaris
Lupus erythematodes
Scrophuloderma
Lichen scrophulosorum |
22
3
6
2 |
|
Strumous glands
Strumous ulcers
Strumous abscesses |
9
2
1 |
|
