2236 



DYSIDROSES AND DYSTROPHIES 



Ochrodermatosis. 



Synonym. — The yellow disease (Castellani). 



Historical and Geographical. — This condition has been described 

 by Castellani in Ceylon, in Europeans living in the low country. 



iEtiology. — Unknown. The patients were not taking any drug 

 and were not exposing themselves to the action of any toxic sub- 

 stance. On the strength that the condition gets much better or 

 disappears on the patient going to the hills, a search for a possible 

 causative organism was carried out, but with negative results. 



Symptomatology. — The face, arms, hands, and at times the whole 

 body, are of a bright yellow or saffron colour, quite different from 

 the yellowish-greenish colour of jaundice. The scleroticse remain 

 completely white; the urine is of normal colour and composition; 

 the sweat is not coloured; the stools are normally pigmented; 

 the liver and spleen are not enlarged; and the general health is in 

 no way affected; but naturally the patients greatly object to the 

 disfigurement. The condition improves or disappears on the 

 patient going to the hills or to Europe. 



Diagnosis. — The bright yellow or saffron colour is different from 

 the yellow colour generally seen in jaundice. Moreover, the 

 scleroticse remain white, and the urine and stools are of normal 

 colour. The anamnesis and special analysis of urine for picric 

 acid, etc., exclude the ordinary toxic pigmentations. The condition 

 is distinguished from certain types of chromidrosis, as the sweat is 

 not coloured and the clothes do not become stained. 



In ochronosis, which is generally congenital, there is alcaptonuria, 

 and the ligaments and cartilages become blackened. 



In xanthoderma areatum the yellow patches remain localized to the 

 legs, and are permanent. 



Treatment. — The only successful measure seems to be to send 

 the patients up-country.' On the hypothesis that the condition 

 might possibly be of parasitic origin, a formalin spirit lotion 

 (i per cent.) was prescribed is several cases, but the improvement, if 

 any, was very slight, though certain patients stated that they 

 thought the condition was affected in a beneficial manner by it. 



Melanonychia. 



Synonyms. — Black pigmentation of nails, Melanonychia falci- 

 formis. 



Castellani has described in two European ladies a peculiar con- 

 dition of the nails characterized by a band of black pigmentation 

 along the free border of the nail. On superficial examination, it 

 has the same appearance as though some dirt had accumulated 

 beneath the free border of the nail, but on scraping this pigmen- 

 tation does not disappear, and this shows that the condition is due 

 to some pigmentation in the substance of the nail. The sufferers 

 were in general good health, not using any internal or external 



