2248 MISCELLANEOUS DISEASES 



Diagnosis. — The disease with which craw-craw presents the 

 greatest resemblance is prurigo. It is distinguished from prurigo 

 by the eruption appearing at any time of life, and not only in child- 

 hood; by most of the papules being larger, of horny consistency, 

 and not covered by a small bloody crust, as is often the case in 

 prurigo; and by the fact that it may be cured spontaneously. 



The disease may be distinguished from tinea corporis by the 

 absence of any fungus, and from scabies by absence of burrows, and, 

 of course, the absence of the Acarus. 



Treatment.—The regular application of a sahcyhc spirit lotion 

 (2 per cent.), followed by /3-naphthol ointment (5 to 10 per cent.) for 



long periods of time, often induces 

 a marked improvement, and in 

 many instances a cure. Internal 

 treatment (arsenic, ichthyol, etc.) 

 does not seem to influence the 

 disease. 



Dermatitis Pruriginosa Tropica 

 (Cooly Itch). 



The term ' cooly itch ' is often appHed 

 to dermatoses of various nature, in- 

 cluding scabies. We use it to denote 

 an extremely pruriginous dermatitis 

 affecting coolies and occasionally Euro- 

 peans in certain parts of the tropics, 

 especially in the low country. No acari 

 or similar parasites are found. 



iffitiology. — The aetiology is unknown ; 

 neither fungi nor animal parasites have 

 been found. It may possibly be due 

 to some parasitic agent which remains 

 on the body only for a short time in 

 analogy to Copra itch (p. 2215). 



Symptomatology. — The eruption is 

 generally found on the arms and legs, 

 but may extend all over the body, 

 even, though rarely, to the face. The 

 patient complains of unbearable pruritus. 

 The eruption is made up of small papules 

 often covered by bloody crusts; vesicles, 

 Fig. 880. — Craw-Craw. papulo-pustules, and pustules may be 



present, and the patient, on superficial 

 examination, may be considered to be suffering from scabies, but no 

 cunicula are found, and no acarus is observed. 



Prognosis. — The eruption is very obstinate, and may last for months. 

 Diagnosis. — The absence of cunicula and of the sarcoptes differentiates it 

 from scabies. 



Treatment. — Sulphur {3 to 10 per cent.) and naphthol ointments (3 to 10 per 

 cent.) are very useful, though their action, as remarked by Daniels, is much 

 slower than in scabies. 



