THE PYOGENIC DERMATITES 



2029 



Purulent Folliculitis of the Legs. 



Definition. — A purulent inflammation attacking many hair 

 follicles of the legs and thighs. 



Historical and Geographical. — The condition is extremely common 

 in Ceylon and Southern India, in the former especially among the 

 moormen. It'was investigated by Castellani some years ago. A 

 very similar or identical condition has been noted by R. Cranston 

 Low in Scotland in miners working in mines flooded with water. 



^Etiology. — It is apparently due to the usual pyogenic cocci. 



Symptomatology .^The patient presents on his legs — especially 

 the extensor region — numerous whitish conical pustules. Each 

 pustule is pierced by a hair. The pustules remain, as a rule, separate, 

 do not increase in size to any extent, and do not coalesce nor form 

 crusty lesions. After a time the skin of the legs may show a 

 peculiar parchment-like appearance. The examination of the pus 

 contained in the pustules shows the presence of the ordinary 

 staphylococci. 



Prognosis. — The disease, if left untreated, runs a very long course. 



Treatment. — The treatment consists in depilation, application of 

 antiseptic dressings, and, later, the application of an antiseptic 

 ointment or paste. In obstinate cases the opsonic treatjnent, 

 carried out with a vaccine prepared from the staphylococci grow^ 

 from the lesions, gives good results. The following ichthyol appli- 

 cation may be found useful: — Ichthyol, 2 drachms; glycerine, 

 I drachm ; distilled water to i ounce. 



THE PYOGENIC DERMATITES. 



Definition. — -The pyogenic dermatites are inflammations pre- 

 dominantly of the surface of the skin, which are caused by the 

 pyococci. 



Remarks. — The old term eczema was introduced by ^Etius of 

 Amida, in the sixth century a.d., for the breaking out of burning, 

 itching, non-ulcerating vesicles, and was used by Willan for an 

 eruption of minute vesicles, non-contagious, closely crowded together, 

 formingthinflakes and crusts when the fluid they contain is absorbed, 

 and due to irritation whether internally or externally apphed. The 

 causes which Willan had in mind were mercury applied internally 

 and the rays of the sun externally. 



After years of confusion the modern tendency is to consider that 

 the word ' eczema ' is a cloak for ignorance. 



In lieu of it the word ' dermatitis ' may be employed, if by this is 

 meant an inflammation predominantly of the surface of the skin. 

 So defined, dermatitis may be classified into:- — 



1. Dermatitis due to chemical causes. 



2. Dermatitis due to physical causes. 



3. Dermatitis due to parasites. 



