2020 



PYOGENIC DERMAL INFECTIONS 



* pemphigus,' for it is much more closely related to impetigo, of 

 which we consider it to be a variety. The eruption attacks gener- 

 ally the axilla, the inguinal and crural regions, from whence it 

 often extends to the abdomen and back and limbs, rarely affecting 

 the face. It is extremely contagious, and is generally more severe 

 in individuals who perspire profusely and suffer from prickly heat. ^ 

 The eruption is made up of flattened, roundish vesicles, which 

 quickly enlarge to the size of a small pea. Very large, flabby, 

 pemphigoid bullae may occur, but not very frequently. Tlie 

 contents are at first transparent, but soon become turbid. The 

 vesicles are often surrounded by a pinkish or reddish inflammatory 

 halo. On being pricked, the vesicle collapses. The eruption 

 does not usually affect the general health, but may be very per- 

 sistent, and may be followed by crops of boils. As soon as the 

 patient goes to the hills or to a cool climate it disappears spon- 

 taneously. 



That the malady is merely a type of pyosis or impetigo due to the usual 

 pyogenic cocci is shown by some cases presenting the typical bullae on the 

 axillary regions, and soon after or — though rarely — at the same time boils 

 on the arms and legs and impetiginoid lesions on the face. 



Diagnosis. — ^This is generally easy, the only difficulty being with 

 chicken-pox. The absence of fever and the situation of the vesicles, 

 which in pyosis mansoni usually appear in the crural or the axillary 

 regions, however, should be sufficient to exclude this. The absence 

 of crusty lesions differentiates the disease from the common type 

 of impetigo contagiosa. 



Prognosis. — The eruption is very persistent, but does not affect 

 the general health, except when complications such as boils develop. 



Treatment. — In severe cases treatment by an autogenous vaccine 

 may be tried. Locally the affected regions should be disinfected 

 regularly twice daily with a solution of per chloride of mercury (i in 

 2,000), carbolic acid (2 per cent.), permanganate of potash (i in 

 4,000), hydrogen peroxide (10 percent.), cyllin (i in 300), lysol or 

 lysoform (2 to 5 per cent.). After this the vesicles are pricked, and 

 the parts again washed with the disinfectant, an antiseptic powder 

 being then thickly applied, such as: — 



In some patients an ointment (europhen, 2 per cent.; protargol, 

 5 per cent.) answers better; the protargol ointment should never be 

 used for the face in Europeans, as it discolours the skin after a 

 time. It may be noted that in our experience the white precipitate 

 ointment (i per cent.), which is so efficacious in the usual impetigo 



Xeroform . . 



Acidi borici (finely powdered) 

 Talci ven. . . 



Si- 

 Si- 

 §1- 



Europhen . . 

 Talci ven. . . 



3i- 



Dermatol . . 

 Talci ven. . . 



