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LUPUS AND OTHER TUBERCULIDES.
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irregular ring is formed (Fig. 37), or an infiltrated patch with one or two outlying nodules (see plate). Upon the neck the disease often assumes a serpiginous form, spreading at the margin and enclosing a cicatricial area, dotted, perhaps, by a few recently developed nodules (Fig. 38). This form of the disease may have a somewhat acute character, and, though spreading slowly, may increase in extent much more rapidly than does the nodular form seen upon the cheeks.

Upon the ala nasi, which is a frequent site of lupus, a scaly

Fig. 38.—Serpiginous lupus with central cicatrix.

or crusted patch is often seen, with more or less ulceration, and in time a marked deformity as the result of cicatricial contraction (Fig. 39).

The nodules of lupus, when well developed, have a characteristic translucent, jelly-like appearance, and, though feeling firm and resilient to the touch, are much softer than the normal cutaneous tissue. In an advanced stage the nodules and patches of lupus become somewhat scaly and not infrequently soften and ulcerate. In chronic cases seen in adult life the