XIV, 1 Denney: Photographic Study of Leprosy 17 
Fig. 22. A single, large' patch on the back of a leper having a slightly 
pigTnented, rugged, central area and a slightly erythematous 
periphery. 
23. An almost diffuse outcropping of small erythematous macules of 
leprosy, not unlike those of secondary syphilis. 
24. The coalescence of numerous macules of leprosy, giving rise to 
curious circinate designs. 
25. A somewhat unusual herpeslike series of macules of leprosy. 
Plate IV 
Fig. 26. An undeformed hand, aside from the slight spindle shape of the 
fingers; the proximal portions being about normal in appear- 
ance, the distal phalanges being smaller and pointed. 
27. An obviously deformed hand, the spindle shape' being greatly 
exaggerated. Unquestionably in this case of leprosy the 
osseous tissues are not alone in the retrogressive process. 
28. The process of absorption is in progress, and there is some 
distortion of the digits from coincident nerve involvement. The 
thumb of each hand in this case is unattacked. 
29. A more advanced stage; in this case the nails may be seen in 
. their deformed state almost at the point of articulation of the 
first and second phalanges. 
30. The proximal phalanges are almost completely absorbed, the 
thumb of the right hand alone having escaped the process. 
31. A similar irregularity in the absorption of the fingers, the middle 
finger of the left hand being unabsorbed. 
32. The peculiar “telescoped” appearance occasionally seen, in which 
the process of absorption of the osseous tissue has proceeded 
more rapidly than that of the other tissues. 
33. The partial absorption of the metacarpals of the left hand; the 
distorted finger nails remain as horny projections on the palmar 
aspect of the hand. The right hand shows a long scar at the 
site of the metacarpo-phalangeal articulation, the result of 
amputation of infected fingers. The left hand shows no scars 
since the skin has remained unbroken during the entire process. 
