Shell-shock PSORIASIS. Post-traumatic eczema.
Case 313. (Gaucher and Klein, May, 1916.)
A soldier, 28, came to the Saint-Louis skin clinic, May 15, 1916, for leg lesions three months old. These lesions were cicatricial, squamous, irregular-contoured, and had developed following a wound. The lesions were eczematous.
On the trunk, arms and elbow were lesions of psoriasis. These lesions had appeared after shell-shock. The man had been bowled over June 16, 1915, by a marmite. The psoriatic lesions appeared shortly afterwards. The patient had never seen anything of the sort before.
In this case the trauma provoked eczema; the emotion, psoriasis. Gaucher and Klein say that they have been struck by the recrudescence of psoriasis since the outbreak of the war, and remark, also, that there has been a relative increase of new cases since July, 1914.
There are cases of psoriasis following nervous shock, emotion and trauma. Sometimes the psoriatic lesion develops upon the scar of a wound. In the above case, as in the case of a woman of 25, a refugee from the Arras bombardment, the psoriasis began de novo and slowly developed immediately after the catastrophe of the Jena. Five, possibly six, out of eight cases totaled, appear, unlike the case sketched above, to have developed in cases either tuberculous or of tuberculous stock.
Re psoriasis, Vignolo-Nutati remarks that this is a relatively frequent skin disease amongst Italian soldiers. He states that many of these cases are due to nervous shock. Some are related to wounds appearing near the scars. In all cases an emotional disturbance is the chief cause. Vignolo-Nutati had 86 cases of psoriasis in six months, 52 of the men coming from the front. Eighteen of the men said that they had not previously suffered from the disease.