Análisis de la enfermedad dermatológica en 8 Cantigas de Santa María del Rey Alfonso X el Sabio. Parte II: mutilación genital, escrofulodermia, sarna, erisipela y los males del Rey Alfonso / Dermatologic Diseases in 8 of the Cantigas of Holy Mary of Alfonso X the Learned. Part 2: Genital Mutilation, Scrofuloderma, Scabies, Erysipelas, and the Ailments of the King

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[Cutaneous tuberculosis yesterday and today]. / Las tuberculosis cutáneas ayer y hoy.

Cutaneous tuberculosis were very frequent in Europe until the middle of the 20th. Century in which their incidence decreased drastically as a consequence of the specific treatments. On the other hand, the M. bovis caused infections which were previously very common have also been disappearing due to control of milk and the livestock produced for eating purposes. Cutaneous tuberculosis have classically been divided into two groups: typical tuberculosis, with follicular structure and demonstrated bacillus by culture or inoculation and atypical tuberculosis (tuberculids), in which there are no follicular structure and the bacillus is not isolated. Its relationship with tuberculosis is principally based on the personal and/or familial background and on the strong positivity of the Mantoux reaction. The concept of tuberculide has always been under debate. Above all in the second half of the 20th. Century, most of the authors were skeptical in regards to its tuberculous etiology. However, since the 1990's, determinations of bacillary DNA in the lesions by the PCR technique has made it possible to demonstrate the M. tuberculosis in them. At present, due to the probably re-emergence of tuberculosis in general as consequence of the immunodeficiency (AIDS), of the M. tuberculosis strains resistant to treatment, and of the cases imported by immigration, some increase in the incidence of cutaneous tuberculosis can be predicted in the future, although it need be feared that this will reach the amounts of other periods. On the other hand, immunodeficiences have made the anergic forms, such as tuberculosis cutis miliaris diseminata or tuberculous gumma, which were previously rare, less rare al present.

Sir William Osler and the anatomical tubercle.

Tuberculosis of the skin resulting from direct inoculation of a tuberculin-sensitive individual (tuberculosis verrucosa cutis) is a rare disease first described by Laennec. Various terms, including prosector's wart and the anatomical tubercle, have been used to describe these lesions, which were often acquired in the autopsy room. The disease usually remains local in those patients with acquired immunity from previous infection with tuberculosis. Sir William Osler possessed an abiding interest in pathology throughout his career and performed nearly 1,000 postmortem examinations. He describes the acquisition of numerous prosector's warts and their evolution and treatment. It is postulated that Osler was a tuberculin-sensitive individual at the time he acquired his anatomical tubercles. His contributions to dermatology are discussed.