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PYOGENIC DERMAL INFECTIONS 



The term eczema should only be used when the practitioner is 

 unable to assign its proper cause to a dermatitis. The term is there- 

 fore a cloak for ignorance of the causation of the dermal condition. 



In the present section we are considering a part of the third class 

 of dermatites — viz., those due to parasites — and in particular that 

 subclass which is brought about by the pyococci. 



We, however, propose to further restrict our remarks to merely 

 the streptococcal dermatites, and will consider them under two 

 headings — -viz. : — ' 



Primary Streptococcal Dermatites. 

 Secondary Streptococcal Dermatites. 



The Primary Streptococcal Dermatites. 



Definition. — A primary streptococcal dermatitis is an inflammation 

 predominantly of the surface of the skin, localized or generalized, and 

 caused by streptococci. 



Remarks, — Streptococci appear to have been first observed in 

 cutaneous lesions by Crocker in 1881, and to have been later 

 identified by Brockhart as Streptococcus erysipelatosus Fehleisen, 

 1883. Later they were carefully described by Whitfield, Colcott 

 Fox, and many other observers, including ourselves. Colcott Fox 

 classified streptococcal skin lesions with those which occur in the 

 course of grave systemic affections, those which are lesions of the 

 hypoderm, those which are primary, and those which are secondary 

 cutaneous lesions. 



With regard to the primary streptococcal dermatites, these are 

 sufficiently numerous, but for our present purpose we will restrict 

 our attention to those found in the tropics, which are dermatitis 

 veldis, dermatitis pratensis, and dermatitis cupoliformis , which may 

 be distinguished from one another as follows : — 



A. Nodules not produced : — 



I. Begins as aflarge blister or bulla, and forms a super- 

 ficial sore with ragged edges, and a fresh clean floor 

 in recent, or a parchment-like floor in old cases — 

 Dermatitis veldis. 

 II. Begins as a small irritable papule or papulo-vesicle, 

 which ulcerates, glazes over, spreads, and finally 

 gives rise to an area defined by a raised margin, inside 

 which are deep fissures and ulcerated areas, and often 

 in later stages papillomatous outgrowths — Dermatitis 

 pratensis. 



B. ' Nodules produced — Dermatitis cupolijormis. 



Dermatitis|Veldis. 



Synonyms. — Veld sore, Barcoo rot, Gift zeer. Brand zeer. 

 Definition. — A primary streptococcal dermatitis characterized by 

 the formation of a bulla, followed by a superficial sore, which 



