2252 



M ISC ELLA NEO US DISEA SES 



months, and often recurring. When the eruption heals, no hyper- 

 pigmentation is left.) 



Diagnosis. — From pityriasis rubra pilaris by the papules never 

 showing plugs and by the absence of scaling; from lichen planus by 

 the papules not being flattened, nor polyhedric, nor umbilicated; 

 from dermatitis nodosa rubra by the papules being always follicular 

 and not so large; from a syphilide by the intense pruritus; from 

 papular eczema by the papules being always follicular and larger 

 and dome-like, with absolutely no inflammatory base, and by the 

 skin not presenting a diffuse inflammation, whatever the stage of 

 the disease. Moreover, even when the eruption is of long standing, 

 the appearance of the skin between the papular elements remains 

 quite normal, and there is no sign of what the French call lichenifi- 

 cation. 



Prognosis. — The eruption lasts for several months, but generally 

 heals spontaneously; recurrences are observed. The general health 

 is not affected. 



Treatment. — Potassium iodide, mercury, and arsenic have no 

 effect. Externally, antipruriginous lotions and ointments may be 

 used — as, for instance, a salicylic alcoholic lotion (2 per cent.), 

 followed by a naphthol ointment (2 to 5 per cent.). Change to a 

 cool climate is very beneficial. One of our cases improved on a 

 vegetarian diet. 



SYMMETRICAL EAR NODULES. 



This condition has been described by one of us in Ceylon in 1910, 

 but further experience will probably show that it is to be found also 

 in other tropical countries. In the deep substance of the lobule of 

 both ears — generally the condition is symmetrical' — on palpation, 

 a spherical nodule, hardly visible, is felt. Now and then the 

 nodule becomes much larger, very tense, and may then present a 

 somewhat translucid appearance ; after some days it becomes 

 smaller again, and may be hardly visible. There is, as a rule, no 

 subjective symptom during the periods of quiescence ; a feeling of 

 tension and slight pain during the periods of increase of size of the 

 nodules. 



The condition is not leprotic, there being no ansesthesia or 

 other sign of leprosy; it may possibly be of parasitic origin, but 

 nothing definite can be stated, as none of our patients would 

 allow the removal of the nodule. Further investigation may show 

 that it is alhed to the pecuhar condition called Nepaul tumour 

 (see Chapter XC, p. 2010). 



EAR LIPOMATA. 



Symmetrical lipomata of the lobules are not rare (see Chapter XC, 

 p. 2010). 



