ECZEMA. 



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ma rubrum, et impetiginosum, of the face used formerly to be called 

 pomgo larvalis, tinea faciei, crusta Zactea, crusta serpiginosa, etc. 

 It often extends into the external auditory meatus, and still more fre- 

 quently is complicated with coryza, with ophthalmia, and with enlarge- 

 ment of the submaxillary and cervical glands. In many cases facial 

 eczema is confined to the ears, the eyebrows, the eyelids (especially 

 the commissures), and, above all, to the lips. These points are some- 

 times studded with vesicles ; sometimes stripped of their epidermis 

 and bathed in liquid secretion, or covered by scabs, and sometimes 

 again they are attacked by the squamous forms of the eruption. A 

 very obstinate species of eczema rubrum is also observed about the 

 nipples of nursing women, although it may also attack the nipples of 

 women who are not nursing, and even those of children. The vicinity 

 of the navel is also the seat of a partial eczema which is most common 

 in corpulent persons. A very important variety of the disease is 

 eczema pudendorum. In men, it usually attacks the penis and scro- 

 tum ; in women, the labia majora. Sometimes it is acute, assuming 

 the simple form ; sometimes chronic, when it presents a very moist 

 eczema rubrum. The intolerable itching which accompanies it almost 

 drives the patient to desperation. A similar eruption appears about 

 the anus and upon the perineum, only its secretion is not so profuse 

 as in eczema pudendorum. Under the name of eczema marginatum, 

 Hebra describes an eruption which is most common among shoemakers 

 and cavalry soldiers. It commences at the point where the scrotum 

 comes into contact with the thigh, but usually extends ; and after a 

 while a similar spot appears symmetrically upon the inner surface of 

 the other thigh. Eczema of the lower extremities is most common 

 upon the legs, where it forms large red patches, which either secrete 

 profusely or else are covered by scabs. This is generally called " salt 

 rheum." When the eruption attacks the flexures of the joints, they 

 become covered by a layer of rough crisp epidermis, mingled with dried 

 exudation, which is apt to crack when the joint is extended, and to 

 form painful fissures. Sometimes a moist eruption also appears on the 

 flexures of the joints. It is remarkable that eczema always attacks 

 the hands and feet simultaneously. When its chief seat is upon the 

 dorsum of the extremity, the eruption takes the simple vesicular form, 

 and may easily be mistaken for scabies. Vesicles are not so apt to 

 form upon the volar surface. More usually there is a hard and some- 

 what thick crust of dried exudation, mixed with epidermis, upon the 

 reddened cutis, and as this coating of the palms and soles is con- 

 stantly scaling off in the form of white scales, eczema at these points 

 is often and erroneously called psoriasis, for pityriasis, palmaris, 01 

 plantaris. 



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