ACNE. 395 



red, hard, and very painful to the touch. After a short time the 

 nodules become soft, discharge spontaneously a more or less amount 

 of bloody pus, and contain in some cases cores of necrotic tissue. 



Occasionally we see the union of a number of these acne nod- 

 ules, so that the skin presents a bluish-red discoloration and dies 

 or becomes purulent, as if the skin was undermined by purulent 

 collections ; this may appear all over the body. 



This " non-acarian " acne very often produces bad results. It 

 has a great tendency to extend in almost all directions, and the 

 cicatrices which appear after healing of the disease leave bare 

 spots all over the body, pink in color, streaked with lines of black 

 pigment deposits. 



Therapeutic Treatment. The treatment consists in the ener- 

 getic local application of various preparations externally. If the 

 aeneous nodules are in the early part of their development, we 

 must puncture them, or open the follicles by some strong antiseptic, 

 such as salicylic or naphthalin ointment. In cases where puru- 

 lent disintegration has gone on it is advisable to open the pustules. 

 This is best performed by means of a small bistoury, and then 

 fill in the opening with boric creolin, or paint it with disinfecting 

 solutions, such as pyoktanin solution (1 to 10 of alcohol), or a 1 

 to 1000 solution of corrosive sublimate. This should be used 

 once a day when the acne is developing. 



R.— Acid, salicylic 20.0 



Oleum olivse 40.0 



Lanolia 80.0 



8. — Put a small portion on the parts once daily. 



The following should be used when the pustules have been 

 emptied : 



B.— Creolin 1.0 



Acid, boraci 40.0 



Frohner advises curetting the cavities and the use of the creolin 

 ointment just mentioned, and in some cases cauterization with 

 nitrate of silver, or powdering with iodoform and tannic acid. 

 In cases of circumscribed acne it is advisable sometimes to cut out 

 the diseased portion of the skin. 



