From Nfavs, November 22-1884. 
fn4l nuki I . * T ■ 
PRELIMINARY NOTE ON THE RELATION OF 
DERMATITIS HERPETIFORMIS TO HERPES 
GESTATIONIS AND OTHER SIMILAR 
FORMS OF DISEASE.1 
LOUIS A. DUHRING, M.D., 
PROFESSOR OF SKIN DISEASES IN THE UNIVERSITY OF PENNSYLVANIA. 
In my original communication on Dermatitis 
Herpetiformis,2 the symptoms, characteristics, and 
the several varieties of the disease were described. 
It was also stated that the pustular variety was the 
same manifestation as that described by Hebra as 
impetigo herpetiformis. The view was likewise put 
forth that the herpes gestationis of authors was 
probably merely another variety of this affection. 
In a more recent paper, just read before this Asso- 
ciation,8 the relation of the impetigo herpetiformis 
of Hebra to dermatitis herpetiformis has been shown, 
and the conclusion reached that the former is but a 
variety of the latter disease In the present note I 
desire to bring forwards supplementary views which 
have of late been forced upon me by study of the 
literature of the subject, to the effect that not only 
the herpes gestationis of writers, but also other simi- 
lar forms of eruption reported with various titles are 
1 Read before the American Dermatological Association, 1884. 
2 Read before the Amer. Med. Assoc., May 6, 1884, and pub- 
lished in the Journ. of the Amer. Med. Assoc., August 30, 1884. 
3 Journ. of the Amer. Med. Assoc., Aug. 30, 1884. all merely instances of one process, namely, derma- 
titis herpetiformis as I have defined this disease. 
To be more definite, some of these cases may be 
mentioned. 
The “herpes circinatus bullosus” of Erasmus 
Wilson;1 the “ pemphigus prurigineux ” of Hardy;2 
the “herpes gestationis ” of Milton,3 Bulkley,4 
Thompson,5 Liveing,6 Cottle,7 Gale,8 and W. G. 
Smith,9 all represent manifestly the same disease, 
and are expressions of the vesicular and bullous 
varieties of dermatits herpetiformis. In like manner 
the “pemphigus” of Klein;10 the “pemphigus cir- 
cinatus,” of Rayer;11 the “herpes phlyctaenodes” of 
Gibert;12 the “pemphigus aigu pruriginosus” of 
Chausit,13 and the “pemphigus compose” of De- 
vergie.14 Certain cases of so-called “hydroa,” should, 
I think, also be viewed as forms of dermatitis herpe- 
tiformis, as, for example, the cases reported by Hand- 
field Jones15and Bulkley,16 and that of “ Florence 5.,” 
1 Diseases of the Skin. Sixth ed. London, 1867. 
2 Lemons sur les Mai. de la Peau, 2d part, p. 136. 2d ed. 
Paris, 1863. 
3 Path, and Treat, of Diseases of the Skin. London, 1872. 
Page 205. 
4 Amer. Journ. of Obstetrics, February, 1874 
5 Archives of Derm , October, 1875. 
6 Lancet, June 1, 1878, p. 783. 
7 St. George Hosp. Rep., 1879. 
8 Lancet, 1880, vol. i. p. 601. 
9 Dublin Journ. Med. Sci., 1881, 3 s., Ixxi. p. 70. 
10 Allg. Wien. med. Zeitung, August, 1867; quoted in Journ. 
Cutan. Med., July, 1868, p. 203. 
11 Treatise on Diseases of the Skin. English translation. Lon- 
don, 1835, p. 219. 
12 A Practical Treatise on the Special Diseases of the Skin. 
English translation. London, 1845, p. IxB. 
13 Annales des Maladies de la peau et de Syph. March, 1852. 
14 Mai. de la Peau, p. 309. Paris, 1857. 
15 Med. Times and Gaz., September 6, 1873. 
16 Archives of Derm., April, 1877. described in the British Medical Journal, 1870. 
Likewise such cases as that of Oswald,1 reported with 
the heading “a peculiar skin eruption occurring 
during pregnancy;” and of Leigh,2 a “bullous erup- 
tion of a peculiar character. ’ ’ 
The very unusual case of Jarisch,3 designated 
“herpes iris,” and the case of Meyer/ “a fatal 
pemphigus-like dermatitis,” have also points in com- 
mon with the disease under consideration. 
Finally, without doubt some cases of so-called 
pemphigus, especially of “ pemphigus pruriginosus,” 
might more properly be regarded as examples of 
dermatitis herpetiformis. 
1 Lancet, June 10, 1882, p. 951. 
2 Lancet, January 6, 1883, p. ix. 
3 Viertlj. flir Derm. u. Syph. 2u. 3 Heft., p. 195, 1880. 
4 Archiv flir path Anat. u. Phys. November, 1883, p. 185,