DYSIDROSES 



2227 



an inflammatory halo; they very rarely coalesce, and usually do not 

 break, but dry up gradually, being thrown off with the exfoliating 

 epidermis. The vesicles in many cases are few in number ; in others 

 they may be numerous, and the eruption may extend to the palms, 

 backs of the hands, and occasionally the arms. There is unbearable 

 pruritus, and in some cases, owing to the scratching, an eczematous 

 dermatitis may develop, especially between the toes. 



Diagnosis. — Some authqjrities still maintain that cheiropompholyx 

 is merely eczema. In our experience, the disease must be separated 

 from eczema, the principal characters of differentiation being the 

 deep situation of the vesicles, the fact that they very rarely rupture, 

 and that, as a rule, they are not surrounded by an inflammatory 

 zone; moreover, the parts affected are generally bathed in sweat. 



Prognosis. — The disease is not a serious one, and, under proper 

 treatment, the eruption heals; but the tendency to recur is great. 



Treatment. — When the vesicles are few in number, pricking them 

 with a sterile needle, washing them with a perchloride lotion (i in 

 2,000), followed by the apphcation of a i to 2 per cent, naphthol oint- 

 ment, gives much relief. When the vesicles are numerous, and the 

 eruption has spread to the backs of the hands and arms, calamine 

 lotion, to which a little menthol and alcohol has been added, answers 

 well, or a salicylic alcoholic lotion (ac. salicyl. 3i., alcohol rect. giv., 

 aq. ad gviii.) may be used, 



Dysidrosis exfoliativa. 



This affection, described by Castellani, is closely related to 

 cheiropompholyx. The affected parts — generally the palms of the * 

 hands — are bathed in continuous perspiration, and large flakes of 

 epidermis exfoliate. In most cases no cheiropompholyx-like vesicles 

 are found; in fact, no vesicles of any type can be detected. The 

 affection becomes cured spontaneously on the patient going to the 

 hills or during the cold season, but it is apt to recur. 



Bathing the affected parts with a resorcin lotion (J per cent.) at 

 first, and later, when the desquamation has ceased, the apphcation 

 of calamine lotion, is useful. 



Sweat Desquamation. 



Schornberg has applied the term * sweat desquamation ' to the minute 

 whitish scales, often arranged in rings, and found on the palms of persons 

 who perspire profusely. The condition may occasionally be confused with 

 a S5rphilide, from which it is differentiated by the absence of other syphilitic 

 signs, such as enlargement of the lymphatic glands, etc., and by the fact 

 that it disappears on the patient going to the hills. 



DYSTROPHIES. 

 Leucoderma. 



Synonyms. — Leucopathia, Vitiligo, Acquired leucopathia, Ac- 

 quired leukasmus, Acquired achromia, Acquired piebald skin, Mala- 

 die de depigmentation (O'Zoux). 



