PYOSIS CORLETTI 



2025 



Diagnosis.- — The important diagnostic characters of the eruption 

 are the absence of constitutional disturbance, the absence of severe 

 itching, the presence of relatively large bullae arising from apparentty 

 sound skin and not surrounded by inflamed areolae, the absence of 

 marked incidence on the axillary and scroto-crural regions, the 

 absence of crusts and of streptococci, the presence of Aurococcus 

 mollis, and finally the ready reaction to treatment by a vaccine 

 prepared from this organism. 



[^Differential Diagnosis. — The differential diagnosis must be made 

 from impetigo contagiosa, dermatitis bullosa plantaris, pemphigus 

 acutus, and pyosis mansoni. 



It can readily be differentiated from impetigo contagiosa by 

 the absence of crusty lesions as a rule, and by the fact that 

 even when the youngest vesicle is examined by Sabouraud's 

 methods no streptococcus can be found and only Aurococcus 

 mollis (Dyar). 



From dermatitis bullosa plantaris it may be distinguished by not 

 attacking the soles of the feet as far as has been recorded, by not 

 extending between the toes, and by the absence of streptococci and 

 Epidermophyton cruris Castellani. 



From pemphigus acutus it can be recognized by the absence of the 

 severe constitutional disturbance. 



From pyosis mansoni it can be differentiated by the fact that it 

 does not begin in the axillae or scroto-crural regions, and that it 

 but rarely, and then lightly, attacks those parts which are the 

 primary seat of Hanson's pyosis. 



The principal feature of the eruption in Hanson's disease is 

 flattened, roundish vesicles which enlarge to the size of a small pea, 

 while large, flabby, pemphigoid bullae are rare; but in this eruption 

 large pemphigoid bullae are common. In Hanson's pyosis the 

 vesicles are often surrounded by a pinkish or reddish inflammatory 

 halo, which is absent in the present eruption. 



Complication. — Eruptions of boils may occur. 



Sequela. — When cases are not treated by vaccine therapy there 

 appears to be a liability to boils as a sequela. 



Prognosis. — The prognosis is excellent, as the disease is rapidly 

 cured by a combination of vaccine and local therapy. 



Treatment. — ^The best form of treatment is to prepare a vaccine 

 which is to be administered in 200 and 450 million doses, with 

 intervals of two to three days between each dose. 



In order to expedite the cure local treatment is also useful, 

 and this consists in pricking each blister and catching the exuding 

 fluid on swabs dipped in i in 1,000 lotio hydrargyri per- 

 chloridi. 



After pricking, each blister should be thoroughly disinfected with 

 the same lotion, and be dusted with some antiseptic powder, the 

 cheapest, but not the best, being boric acid, while the same with 

 starch should be used for dusting the clothing in order to attempt 

 to prevent the spread of the infection. 



