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Herbert K. Fidler, M.D.
JAMA. 1937;108(24):2034-2035. doi:10.1001/jama.1937.92780240001008.
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The importance of differentiating between the lesion found in first infection tuberculosis and that resulting from reinfection was recognized first by Ghon1 in 1912. Since then it has been customary to think of the primary tuberculous lesion, found most frequently in childhood, as confined chiefly to the lung, because most of his cases were of this type. This is probably true; but if the site of initial entrance of the tubercle bacillus is through the skin the resulting lesion differs from the well recognized types of adult skin tuberculosis (verruca necrogenica, lupus vulgaris and tuberculosis colliquativa) in a manner similar to that in which the childhood pulmonary lesion differs from the adult pulmonary lesion. This concept is not new, as Ghon in his original communication reported one case of primary skin tuberculosis as well as several cases in which the site of entry had been the tonsil or bowel.


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