DYSTROPHIES 



Treatment. — -The treatment is very unsatisfactory. The patient 

 must be advised not to expose himself to the sun and glare, though it 

 is doubtful whether the condition is directly due to such exposure. 

 A wide-brimmed topee or sun-helmet lined with red cloth may be 

 used. 



Of the many drugs tried ichthyol seems to be the only one which 

 at times keeps in check the condition, occasionally inducing a 

 slight improvement. It is given internally in 5 grain doses three 

 times daily before meals, and an ichthyol ointment or lotion 

 (5 per cent.) may be apphed to the affected skin at night, while 

 during the day a calamine lotion may be used. 



Mercury, potassium iodide, and arsenical preparations are useless. 



Dermatosis Nigro-Anulata. 

 Historical and Geographical. — This condition has been described 

 by Castellani in Ceylon natives and in a very dark-skinned gipsy 

 in Macedonia. 



etiology and Pathology. — This is unknown. It is not a framboe- 

 side, as the lesions are not influenced by salvarsan and potassium 

 iodide; nor a syphilide, as they are not influenced by the same drugs 

 nor by mercury ; moreover, Wassermann is negative. 



Symptomatology. — The condition is characterized by the presence 

 of black, elevated, fairly hard, ring-like or elliptical multiple lesions, 

 encircling apparently normal skin. There is no pruritus, sensation 

 normal, Wassermann negative. The course is extremely long, 

 lasting for years, with very little change in the aspect of the lesions. 



Fig, 876. — Dermatosis Nigro-Anulata. 



Diagnosis. — The affection has to be distinguished ivomtinea nigro- 

 circinata by the absence of fungi, and by the failure of any anti- 

 mycotic treatment : from a circinate Jrambceside by the uselessness 

 of potassium iodide and salvarsan; from a syphilide by the useless- 

 ness of the same drugs and of mercury; from porokeratosis jhy the 

 multiphcity of the lesions. 



Prognosis. — ^The general health is not affected, but the condition 

 I is most persistent. 



Treatment, — This is very unsatisfactory. An exfohative 'treat- 

 ment by means of a sahcylic acid ointment occasionally induces 

 a temporary improvement. 



