CHAPTER XCVIII 



MISCELLANEOUS DISEASES 



Craw-craw — Dermatitis nodosa rubra — Lichen convex — Symmetrical ear 

 nodules — Ear lipomata — Porter's lipomata — Subcutaneous nodular lipo- 

 matosis — Multiple pruriginous tumours of the skin — Angiofibroma 

 contagiosum tropicum — Multiple pruriginous tumours — West Indian 

 nodules — Mossy foot — Botryomycosis — The hyperkeratoses — Juxta- 

 articular nodules — Murmekiasmosis — References . 



CRAW-CRAW. 



Synonym. — Nodular dermatitis (A. Plehn). 



etiology. — The cause of the malady is unknown. Pijper has 

 described a diphtheroid bacillus. 



In the Ceylon gaols, where the disease is common, the prisoners believe it 

 is due to the diet and to the manner of cooking the rice. 



O'Neil described in his case a Microfilaria which Manson is inclined to 

 believe to be probably Microfilaria perstans. Nielly described, under the 

 name of 'dermatose parasitaire ' or * craw-craw,' a papulo -vesicular eruption 

 in which he found nematode embryos in the papulo-vesicles and blood of 

 the general circulation. The conditions described by these authors are not 

 the dermatosis we call craw-craw, and resemble more what Daniels and 

 ourselves call cooly itch. 



Symptomatology. — Under the term ' craw-craw * African natives 

 denote practically any pruriginous skin disease. Our African experi- 

 ence has taught us that most of the so-called craw-craw cases are 

 cases of neglected scabies or of tinea corporis, or what Daniels and 

 ourselves call cooly itch. We apply the term ' craw-craw ' to a 

 dermatosis met with in Africa, in Ceylon, and in various parts of 

 the tropics, characterized by the presence of numerous hard, almost 

 horny papules, occasionally slightly exfoliating at the top, varying in 

 size between a millet-seed and a small pea. Some of the papules 

 may be follicular. They are not of constant shape; some may 

 be roundish and flattened, and others acuminate. When disappear- 

 ing, they may leave zones of hyperpigmentation. The eruption 

 generally affects the legs and arms, but may spread to the whole 

 body, excepting, as a rule, the face and scalp. Suppurative and 

 ulcerative lesions are absent, exicept as secondary lesions due to 

 scratching. The proximal lymphatic glands may be hard and en- 

 larged. The disease, if not properly treated, may last many'months, 

 and even several years; some cases, however, become cured spon- 

 taneously. 



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