MACULO-AN ESTHETIC LEPROSY 



1661 



In the lower limb the plantar muscles of the toes maybe affected, 

 while the spread of the paralysis to the peronei and extensors may 

 result in a dropped foot with an internal twist. The reflexes are 

 exaggerated at first, but when paralysis sets in they diminish, and 

 when the muscles waste, the reaction of degeneration may be 

 obtained electrically. 



Fig. 732. — Maculo-An^sthetic Leprosy. 



Trophic lesions may also appear in the form of whitlows in the 

 fingers and necrosis of the phalanges, or, instead of this, a simple 

 absorption of the bone of the phalanx or metacarpal, so that the 

 nail may ultimately appear to spring from the metacarpal, the 

 wrist, or even, it has been said, from the elbow. Similar trophic 

 lesions may appear in the foot. Bullae may appear on the hands 



