DERMATOSES IN METABOLIC DISTURBANCES T01 



ing decubitus. The latter, however, is also the result of marasmus of 

 any origin, and may be independent of central nerve lesions. Whether 

 febrile diseases produce skin changes directly through intoxication, or 

 through the intermediate influence of the central nervous system, is 

 not known, but the hair falls, and the nails become horizontally ridged. 

 Actual distortion of the nails is at times encountered in syringomyelia 

 and Morvan's disease. 



Peripheral nerve disturbances are associated with zoster, although the 

 prominent lesion in zoster is in the ganglia on the posterior roots. Never- 

 theless, the neuralgia indicates a marked involvement of the nerve itself. 

 Simple herpes may be the result of peripheral neuritis. Kreibich has 

 written a monograph on the influence of the nervous system in producing 

 erythemas, wheals, and bulla?. Injury to peripheral nerves at times 

 causes a condition known as "glossy skin," which disappears when the 

 nerve heals, as Paget pointed out. Alopecia areata has bee": regarded, 

 albeit on an inconclusive basis, as the result of a peripheral neuritis. 



Mental obliquity of various types and degrees of intensity is related 

 to certain dermatoses. These are mainly self-inflicted lesions, as in 

 hysterical mutilations; or are the result of habit, or mannerism, as the 

 pulling of hairs, or the consistent scratching of definite areas. The lesions 

 are so artificial in aspect, and so unlike other dermatoses, as immediately 

 to arouse the observer's suspicions. 



Dermatoses Conceived to be Due to or Associated with 

 Respiratory Diseases 



Excepting the polymorphous erythemas and purpuras associated by 

 Osier with asthma, and the infantile eczemas that Czerny found accom- 

 panying the same condition, there would seem to be no relationship be- 

 tween the respiratory tract and the integument. Often nasal obstruction 

 causes a dilation of the cutaneous veins of the nose, but this is purely 

 mechanical a vascular stasis due to an anatomical peculiarity. 



Dermatoses Conceived to be Due to or Associated with 

 Endocrin Disturbances 



Myxedema and Graves' disease cause well-known changes in the skin 

 and hair, so well-known, in fact, that further allusion to them is unneces- 

 sary here. In addition to these, it has appealed to the fancy of many to 

 explain a wide range of dermatoses on the basis of ductless gland dis- 

 turbances. Judgment must be withheld as to the soundness of views con- 

 cerning the cutaneous expression of endocrin changes. That such a rela- 

 tion exists cannot be doubted. What it is, no one yet knows. To date 



