2226 



DYSIDROSES AND DYSTROPHIES 



Spots on the palms and soles, acute patchy congestion in the oral 

 mucosa and pharynx, a syphilide must be excluded, for several of 

 our patients believed themselves to be affected with syphilis; but 

 the extreme pruritus is generally sufficient to exclude it. 



Prognosis.- — As a rule, the prognosis is good, the eruption disap- 

 pearing quickly under proper treatment. The patient, however, com- 

 plains of the severe itching, which often keeps him awake at night. In 

 some few cases no treatment is of any avail, and the patient must be 

 sent up to the hills ; in others, crops of boils develop, or pyosis mansoni 

 or impetigo contagiosa may supervene, especially in children. 



Treatment. — The patient must be kept cool; he should not take 

 much to drink, and should abstain from drinking hot tea. Too 

 warm clothing should be avoided; flannel and woollen things often 

 make prickly heat worse. In such cases silk underclothing may be 

 recommended, but not in people liable to abdominal chills. All 

 underclothing must be changed at least once daily and after taking 

 any violent exercise. Sea-bathing is injurious. The treatment 

 which in our experience has answered best is the free use, several 

 times daily, of a salicylic alcoholic lotion (ac. salicyl. 3i., spir. rect. 

 gviii.), followed by the general application of a salicylic or boracic or 

 camphor powder, such as ac. salicyl. gr. x., talci §i., or ac. borici 3i , 

 talci ven. §i., or camphor gr. xxx:v., zinci ox. amyli aa |ss. It is 

 better, as a rule, to avoid greasy preparations. 



After the eruption is cured the patient should be directed to use 

 some Condy's fluid, cylhn, or other disinfectant in the bath, and 

 afterwards to apply one of the powders mentioned above. 



The so-called ' Castellani's lotion,' much used in the East, consists of 

 menthol gr. x., ac. salicyl. gr. ii., zinci ox. ^vi., calaminae "^iii., spirit, rect. gii., 

 glycerin, ^i., aq. rosae ad §vi. It should be diluted with the same amount of 

 water when applied to the face or when used for children. 



Cheiropompholyx. 

 Synonyms. — Dysidrosis, Pompholyx. 



This affection is seen in the tropics, and is also met with in tem- 

 perate zones during the hot season. To Tilbury Fox and J. Hutchin- 

 son belongs the merit of having separated this affection from eczema. 



.etiology and Histopathology. — Tilbury Fox beUeved the disease 

 to be due to accumulation of sweat induced by the blocking of the 

 pores of the sudoriparous glands. The more recent researches of 

 Unna, Norman Walker, Williams, and others show that the lesions 

 are of an inflammatory character; the vesicles are found in the 

 prickly layer, and often press to one side of the sweat channel. 



Unna described a bacillus as the cause of the disease. Some authorities 

 consider the condition to be of neurotic origin. 



Symptomatology.— The eruption is found in individuals who 

 suffer from hyper idrosis. It is characterized by the presence of 

 deeply seated translucent or opalescent, sago-like vesicles between 

 the fingers and toes; the vesicles are not, as a rule, surrounded by 



