ACANTHOKERA TO DERM I A 459 



The sun's rays cause hypercemia and heatstrokes, the former lead- 

 ing up to subcutaneous oedema and vesication in those frec^uently 

 exposed, resuhing in a thickening of the skin and a deposition of 

 pigment. This condition is seen in pellagrous patients. Cold cream 

 and vaseline are good for sunburn, lead and opium lotions are sooth- 

 ing. Helmets made of pith or rubber so as to protect the head and 

 the nape of the neck should be worn from sunrise to sunset as a routine 

 thing. 



Flannel and cholera belts are often irritating and predispose to 

 prickly heat. Silk or silk and cotton clothing next to the skin is 

 efficacious. 



Alcohol is often taken owing to increased thirst and to a feeling of 

 exhaustion so common at the close of the day. This causes increased 

 perspiration and predisposes to prickly heat; it is not necessary and 

 should be avoided; in any case moderation is essential. 



A daily tepid bath is necessary for skin cleansing. All attempts at 

 the classification of skin diseases are at present provisional and at the 

 best incomplete. Dermatologists are still taking certain varieties from 

 the " Eczema " group and giving to them a definite place in the 

 dermatological " pigeon-hole." 



We feel that it will suit our purpose best to deal with the most 

 prevalent tropical skin diseases alphabetically. 



ACANTHOKERATODERMIA. 



This is a term used by Chalmers to include " liyperkeratoses " 

 accompanied by "acanthosis." 



There are thickened areas of epidermis which may break down or 

 become fissured, affecting the soles and palms. 



This condition is accompanied by hyperkeratosis subungualis. 



The thick horny layer is largely composed of cornified and modified 

 prickle cells. 



ACARIASIS. 



This is an eruption affecting the whole body caused by the 

 Pediculoides ventricosus, the " Acarien " of barley. The eruption 

 may simulate urticaria or scabies, and is characterized by papules of 

 the face, neck, trunk and limbs, or sometimes bv urticarial patches 

 with a small vesicle in the centre. 



The itching is intense and lasts longer than the eruption. 



The symptoms may come on a few hours after handling infected 

 barley, but it clears up itself within twelve hours if not scratched. 



Swelling of the neck and face is rare. 



The condition has been seen in Algeria (Sergent and Alarv). 



Sulphur preparations are indicated. 



