DYSTROPHIES 



2237 



raedicine which could account for the pigmentation, and the nails, 

 apart from this line of pigmentation, appeared perfectly normal. 

 We have, later, come across a case in a European gentleman and 

 another case in Macedonia. 

 The condition slowly disappears spontaneously. 



Xanthoderma Areatum. 



This affection, which has been described by Castellani, is not 

 infrequently met with among Europeans; it generally affects the 

 lower parts of the legs; it starts very insidiously, with a yellowish 

 or reddish-yellow spot, which is not elevated; the surface is smooth, 

 not furfuraceous; there is no infiltration, and, apart from the 

 colour, the affected skin is normal. There is no pruritus and 

 no pain. The yellow spot slowly increases, and one or more other 

 spots may appear near the first one or at a distance. Some of the 

 spots may coalesce together, forming a large yellow-red patch of 

 irregular or various outline. The larger patches also, apart from 

 the colour, are normal, being of normal consistency and elasticity. 

 The disease is very chronic. The general health is not impaired; 

 the lymphatic glands are not enlarged, and the blood does not show 

 any abnormality; urine normal. In all our cases syphilis could be 

 excluded; in none was there any history of traumatism. 



Diagnosis. — From chloasma, xanthoderma areatum is readily 

 differentiated by the lighter yellow or yellowish-red, and by the 

 different situation. The affection can be easily distinguished from 

 xanthoma, as the texture of the skin is normal, and the patches 

 are not elevated. In pseudo-xanthoma elasticum of Balzer there is 

 an eruption consisting of mesh-like patches of buff-coloured infiltra- 

 tion, lumpy in some places, in others linear. It must be distin- 

 guished also from Schamberg's so-called ' cayenne-pepper' condi- 

 tion, characterized by the presence of brownish-yellowish patches 

 on the legs, made up of small puncta, giving rise to a cayenne-like 

 appearance of the skin, found at times on people suffering from 

 varicose veins. 



Treatment. — This is difficult ; in some cases an energetic exfoli- 

 ating treatment byresorcin pastes (resorcin, 3ii. ; ac. salic, gr. xx. ; 

 Lassar's paste, gi.) improves the condition after the inflammation 

 induced by the paste subsides. 



Mongolian Spots. 

 Synonym. — MongoHan maculae. 



Definition. — A congenital condition characterized by the presence 

 of dark bluish spots on the lower sacral region, not disappearing on 

 pressure. 



History. — The first complete description has been given by Baelz, 

 who found them almost constantly in Chinese, Koreans, Japanese, 

 -and Malays. Later Adachi, Ashmead, Martinotti, Consiglio, and 

 others have further investigated the subject. Castor and Fink 



