470 DISEASES OF THE SKIN. 



is an atrophy of the cutis caused by pressure of the crusts and scabs 

 adhering to it. 



Classification of eczema, according to the extent and locality of the 

 surface which it involves, is of much greater importance than that 

 based upon its form and duration. Upon this basis, in the first place, 

 it may be divided into universal and partial eczema. The term uni- 

 versal, however, is not to be accepted literally, because, although the 

 eruption often involves a very large portion of the surface, it seldom 

 covers the whole of it. Universal eczema is a much less common 

 affection than partial eczema. It is either acute, when it usually 

 assumes the simple or squamous character less frequently than 

 that of eczema rubrum; or else it is a chronic disease, and then 

 takes on different aspects upon different parts of the body, showing 

 preference, however, to the type of eczema rubrum, so that the surface 

 is generally either moist and raw, or else covered with large crusts. 

 Chronic universal eczema is always a very distressing and very ob- 

 stinate disease, although it does not imperil life, and indeed often 

 does not seem materially to prejudice the health of the patient. 



Partial eczema is often situated upon the scalp. Even when the 

 disease commences as a vesicular eruption, the vesicles are apt to be 

 overlooked, and to be destroyed by combing or scratching. If eczema 

 impetiginodes, or E. rubrum, appear on the scalp, the eruption dis- 

 charges very freely, the hairs are glued together and crusts form, which 

 are sometimes soft and flat, sometimes thick and hard, and to this 

 the name of tinea favosa, granulata, etc., was formerly applied. Such 

 a scalp, covered with scabs, is a very favorite and favorable abode for 

 lice. The cervical glands often become enlarged in moist eczema of 

 the head, and sometimes even suppurate. The disease presents a very 

 different appearance when the transudation is too scanty to form ves- 

 icles or to burst through the skin. In such cases it assumes the squa- 

 mous type, and a great quantity of small white detached scales of epi- 

 dermis are found, not merely upon the reddened skin, but among the 

 hairs and upon the collar of the coat. This was formerly called tinea 

 furfuracea ; or tinea amiantacea, when the epidermic scales, mixed 

 with exudation, formed thick, shining layers, like asbestos. All forms 

 of eczema frequently appear upon the face, although the impetiginou? 

 and rubrous types are the more prevalent ones during childhood. 

 Although it does not spare other regions, its favorite seat is upon the 

 cheeks and chin, which become reddened and shiny, and after a fe\v 

 vesicles have formed upon them, and burst, they are covered by a clear 

 yellow liquid. This soon dries up, forming yellow crusts. If we re- 

 move these before the disease has subsided, we come immediately upon 

 the bare, moist corium, and can find no intervening epidermis. Ecze 



