_Present condition_ (January, 1905).—On _the hands_ about the knuckles and backs of the fingers are a few minute slightly elevated bluish nodules. On the sole of the _right foot_, especially on the inner part, there are nodules in various stages of development. The minute ones, those in an early stage of development, are slightly elevated and of a bluish colour, similar to those on the hands. Others, further advanced in development, are small, sessile, or pedunculated hard outgrowths, without bluish colour and sometimes covered by thickened epidermis. There is a large patch of pigmented (brown) skin on the dorsal surface of the right foot, and in the neighbourhood of this pigmented area are some minute nodules of similar character to those already described. It is possible that the pigmented skin has been the site of minute growths which have undergone spontaneous involution, and have, as frequently happens in Lichen planus, left pigmentation of the skin behind them. The right thigh and leg are not affected. The _left lower extremity_ is the part most affected by the disease, and there is chronic, rather firm, œdema of the left foot and ankle. The nodules on the left foot are similar to those on the right, but are more widely distributed, and the left foot differs from the right in the absence of the pigmented area and in the presence of the œdema to which we have just alluded. Of the little sessile or pedunculated tumours on the back of the left foot and in the neighbourhood of the ankle-joint (see Fig. 1) the biggest are of the size of a large pea. There are likewise little tumours of various sizes—that is, in various stages of development—on the inner aspect of the left popliteal region (see Fig. 2) and in the neighbourhood of the patella, the smaller ones being bluish and slightly elevated, the larger ones being reddish, lentil-sized, sessile outgrowths. There are no nodules or growths on other parts of the limbs, trunk, or head, with the exception of four or five minute purplish or bluish papules on the _glans penis_ and neighbouring skin. [Illustration: Figure 1.] There is no evidence of any disease of the thoracic or abdominal viscera. The patient is not strongly built, but looks well nourished. He complains of various pains, but whether these are related to the disease or not is doubtful. [Illustration: Figure 2.]