The knife, the cautery, and caustic pastes I have used and discarded, believing that by the skilful use of the curette and burr the disease can be removed with the least amount of pain and discomfort and the least resulting disfigurement. For many years I have used the dental burr of varying size, dipped in carbolic acid, for the destruction of lupus nodules, and ever with increasing satisfaction. This instrument readily penetrates the
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Fig. 42.—Lupus erythematosus.
gelatinous lesions, and when the handle is rolled between the fingers, and the burr pressed in various directions, it bores out the softened lupus tissue as it does the carious substance in a dental cavity and leaves the normal skin uninjured. In diffused patches of lupus, in scrofulous ulcerations, and in verrucous tuberculosis (after the warty surface has been removed by a salicylic-acid plaster) nothing can be more serviceable than the dermal curette.
