MULTIPLE, BENIGN, TUMOR-LIKE NEW GROWTHS

Under the name of multiple, benign, tumor-like new growths a case
has been pictured and described by Schweninger and Buzzi,¹ charac­
terized by lentil- to bean-sized, whitish or bluish-white, rounded or
slightly flattened, circular or oval projections, the larger somewhat puck­
ered. They seem hollow, and when one is pressed in with the finger, it
can usually be pushed below the level of the surface into a concave de­
pression; immediately upon withdrawing the finger it springs up again.
In short, they present the physical characteristics of an elastic, hollow,
bladder-like tumor. The smaller beginning formation is usually rounded,
and when moderately developed, is frequently more elastic than the older,
larger, and often somewhat flattened growth. A variable degree of spon­
taneous involution takes place, although they do not actually disappear,
merely becoming more flaccid, with the skin slightly atrophic, and with
usually, minute scar-like depressions or striations. They appear slowly,
and at first there are relatively few, but the addition of new tumors from
time to time finally results in a variable, but usually considerable, num­
ber. According to Crocker,² the malady has also been observed by Mal­
colm Morris, Colcott Fox, and Van Hoorn. I have met with a similar
instance in a middle-aged woman, with 30 to 40 such bladder-like tumors
over the region of the right shoulder and immediately adjacent part of
the back; they were of extremely slow development, and, as in the other
cases, gave rise to no subjective symptoms. Over the well-developed
and older tumors the integument was distinctly atrophic or cicatricial
looking, but soft and elastic.

The shoulders, trunk, and thigh are favorite situations. There has
been no recognizable cause. Of the 5 cases, 4 were women. Histo-
logically, Buzzi's findings show that the skin alone is involved in their
formation, the elastic fibers being absent in the main part of the cov­
ering integument, and in increased quantity peripherally. This passive
retraction or atrophy of the elastic tissue appeared to be the essential
and primary factor of the pathologic process, and recognizable in all
the lesions, whether small or large, and this fact would place the tumors
among the atrophies, although in their appearance, projection, etc.,
clinically they would naturally be placed among the new growths.
Round-cell collections were noted about the superficial horizontal capil­
lary network and about the vessels of the glandular structures; the seba­
ceous glands showed enlargement. No influence is to be expected from
treatment.

¹ Schweninger and Buzzi, International Atlas of Rare Skin Diseases, 1891, vol. v,
plate xv.

² Crocker, Diseases of the Skin, third edit., p. 702.

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