484 DISEASES OP THE SKIN 



When biting the proboscis is inserted into a sweat duct, the small 

 booklets everted and the skin thus gripped ; the suctorial tube is then 

 protruded until it reaches blood, the salivary glands at the same time 

 inject their venom causing the pruritus; the pharyngeal pump draws 

 blood, the parasite falls off leaving a minute red spot and marked 

 itching. This area is vigorously scratched and pyogenic infection 

 may follow. This condition, when constant with some thickening of 

 the skin and pigmentation, is known as "vagabond's disease." 



The parasites secrete themselves in the folds of the clothing, 

 especially about the seams, and later attack the hairy parts. 



The eggs are attached to the hairs. 



TREATMENT. 



Shave off the hair and apply calamine lotion, or 



Soak the hair in petroleum, wash with soap and water every twenty- 

 four hours, or 



Apply sulphur and resorcin ointment, wash with soap and water, 

 soak in acetic acid, 25 per cent., comb with a tooth-comb to remove 

 the eggs, and Avash again. 



All clothing must pass through steam sterilizers. 



Antiseptic baths and calamine lotions are always useful. 



PEMPHIGUS CONTAGIOSUS (Pyosis mansoni). 



A non-febrile, highly contagious disease of warm countries, charac- 

 terized by large vesicles or bullae without inflammation or ulceration. 

 The fluid is clear, then turbid ; the blister ruptures ; exfoliation of about 

 one inch of skin takes place, and a pinkish scar forms. It may attack 

 any part of the body, but in adults the axillae and groin regions are 

 usually selected. 



The causative organism has not been proven ; it is probably a 

 pyogenic organism. 



Keep the parts clean and dry. Use dusting powder of boric acid, 

 zinc oxide and starch, equal parts. Mercuric lotions should be used- 

 Iron, arsenic and strychnine internally. 



PYOSIS CORLETTI (1915). 



An epidemic eruption of bulla amongst English soldiers in 

 Khartoum, probably identical with Corlett's " Impetigo contagiosa 

 bullosa " in American soldiers. 



Bulla arise from apparently sound skin without fever or pruritus- 

 and spread over the whole body and limbs. 



A diplococcus (Amococcus mollis) is always found. 



The soles are not attacked, there are no crusty lesions, and strepto- 

 cocci are absent. It does not select moist folds of skin, and is not 

 surrounded by an inflammatory zone. 



