298 ' Wolfgang M. Pahl and W. Undeutsch 



Figures 1-3. Specimen No. 1 565 (Provenience: Lower Kgypt. Date; Late Period) 

 of the Mummy Collection of the Institute of Anthropology and Human Genetics, 

 University of Tubingen (F.R.G.): /, anterior view showing skin ulcerations L HI; 

 2, right lateral view with skin ulcerations I. II. IV, V; 3. left lateral view showing 

 skin ulceration III. 



Figures 4-6. Radiographs of specimen No. 1565: 4. posteroanterior projection; 

 5, right lateral projection: 6. left lateral projection. In none of these projections is it 

 possible to identify osseous destruction. 



First, a postmortem origin of the de- 

 fects definitely can be excluded. The 

 radiological investigation in posteroan- 

 terior and right and left lateral projec- 

 tions (Figures 4-6) as well as the dental 

 x-ray (orthopantomography) (Figure 

 13) reveal no signs of osteolytic, meta- 

 static or primary destruction. Instead, a 

 pathological dental process was de- 

 tected, which corresponds to the al- 

 ready mentioned small perforations of 

 the maxilla at exactly the same level of 

 soft tissue lesion III (Figures 1 .3, 1 1 ar- 

 rows, 1 3 arrow). Another examination 

 with a stereoscopic dissection micro- 

 scope proved that the osseous defect 

 corresponds to the apparent apical ab- 

 scesses of the left upper premolars. In 

 all probability, this has no relationship 

 to the cutaneous lesion HI. It can there- 

 fore be postulated that the skin foci are 

 lesions of the soft tissue only, which, at 

 least to date, have not involved the 

 bone. 



Based on the above remarks, the 

 types of diseases relevant for a differ- 

 ential diagnosis of lesions I-IV would 

 be the following:tuberculosis, tropical 

 ulcer, ecthyma, cutaneous leishmania- 

 sis, treponematosis, noma (cancrum 

 oris, cancer aquaticus). 



Because of differing characteristic 

 signs, the following diseases should 

 not be considered in the differential 

 diagnosis: nocardiosis, actinomycosis 

 (shape, developing stages), nontuber- 

 culous mycobacterial ulcer (irregular 

 limited lesions, localization), skin tu- 

 mors and secondary deposits of tumors 

 (development, limitation of the foci), 

 and lepromatous ulceration (shape, de- 

 veloping stages, localization, bone in- 

 volvement). 



TUBERCULOSIS 



In cases of tuberculosis, the lungs and 

 intestines are the primary sites of infec- 

 tion. Dermatological manifestations 

 are extremely rare. Differences be- 

 tween these and ulcerations I-IV con- 

 cern the number of defects (few in 

 tuberculosis), their shape (irregular 

 margins in tuberculosis), extension 

 (mostly shallow ulcerations secondary 



Ziifireh Paffopatholnay Symp. 19Hfi 



