2194 



ULCERATIONS 



Pathology. — -According to Galloway, the microscopical changes 

 begin some distance from the lesion, and consist of a round-celled 

 infiltration into the upper regions of the corium. This induces 

 the papillae to increase in length, thus producing the typical papule, 

 and at the same time causes an elongation of the interpapillary 

 processes of the epidermis, until they are some eight or ten times their 

 original length. 



The connective tissue of the corium swells and disappears, and 

 its place, is taken by a round-celled infiltration, which consists of 

 leucocytes, Unna's plasma ^cells, mast cells, and connective-tissue 

 cells. Giant cell/ are not found. The leucocytes are the ordinary 

 polymorphonuclear leucocytes, while Unna's cells are characterized 



Fig. 864. — Granuloma Inguinale. 

 (From a photograph by Sambon.) 



by possessing a rounded nucleus, with a certain amount of sur- 

 rounding protoplasm containing basophile granules. The connec- 

 tive-tissue cells are spindle-shaped. The cells of the epidermis are 

 modified over the papule by becoming swollen, hyaline, and show- 

 ing mitosis. The stratum granulosum fails to develop its kerato- 

 hyalin granules, and eventually disappears halfway up the papule, 

 as does the stratum corneum, so that on the summit the different 

 layers of the epidermis cannot be differentiated. 



There is neither caseation nor suppuration, but in the older parts 

 of the specimen the cells of the infiltration become swollen and 

 disappear, and in their place there appears cicatricial connective 

 tissue, which causes the papule to shrink and the whole area to 

 assume a scar-like appearance. 



