g86 Pemphigus. Impetigo. 



Symptoms. At times feverish symptoms, perhaps also 

 digestive disturbances, herald an approaching attack, while in 

 other cases the eruption appears without any such signs. On 

 the skin, especially on the trunk, on the lower belly, on the 

 inner surfaces of the thighs and elsewhere, vesicles arise upon 

 the skin which is swollen, accompanied by intense itching or 

 without itching. These vesicles form within 1 to 2 daj^s and 

 may become larger than a goose egg; they are semi-spherical 

 or flattened and may exhibit a plate-like depression in their 

 center. The content is clear watery or yellowish, later on it 

 may become milky, and flows out after the thin wall bursts, 

 while this latter remains adherent to the skin for a long time, 

 or it is removed by rubbing, and then an intensely red surface 

 becomes visible, which for a time continues to exude a serous 

 secretion, but in a few days is covered with new epidermis. 

 In this way the process heals completely in the course of 2 to 4 

 weeks ; in rare cases, however, healing occurs only with the 

 formation of scabs, and then fine glistening cicatrices remain 

 at the places of the vesicles. 



Treatment. After rupture of the vesicles occurs, it is suffi- 

 cient to appl}" a non irritating dusting powder to the skin or an 

 astringent ointment (see page 863); in case of very extensive 

 eruption washing with soap and thorough cleanliness are to be 

 recommended. 



Literature. Basch, T. Z., 190S, 266.— Graffunder, B. t. W., 1890, 15.-5.— 

 Jakobscn, Maanedsskr., 189:5, IV, .Sll.— Liicet, Eec, 1894, 244.— Paulicki, Mag., 

 1872, 29.— Saner, W. F. Tk., 1902, 231.— Winkler, ibid., 1891, 47, 



Pemphigus Chronicus. Frohner saw tlie whole of the liody of a 

 dog, with the exception of the head and limbs, covered with large vesi- 

 cles, which after bursting, left clear liright red surfaces, with a cherry 

 red center. These showed no disposition to heal and were continually 

 covered with fresh crusts, until finally the animal died, completely ex- 

 hausted, with symptoms of hemorrhagic inflammation of the rectum. 



Lafosse saw a skin disease similar to pemphigus foliaceus, in a mule, 

 After all the hair had fallen out, broad epidermal scales formed 

 on the bald skin, after detachment of which the fresh layer of epidermis 

 Ava.s soon lifted up by the exuded serous fluid underneath, and in this 

 Avay new scales always were formed. The animal meanwhile became 

 emaciated, and later on was attacked by diarrhea. (Frohner, Monh., 

 1892, III, 497.) 



13. Impetigo. 



{Ecthyma.) 



By impetigo or ecthyma is understood in human medicine an ex- 

 anthema chiefly affecting children, in the course of which pustules form 

 on different parts of the body, but especially on the face; they develop 

 on a red base without itching, and are followed later on by thick, 

 soft, honey-like crusts. This skin affection is sometimes decidedly in- 



