2234 



DYSIDROSES AND DYSTROPHIES 



Dermatosis Festonata Frontalis. 



Historical and Geographical. — This condition has been described 

 by Castellani in Ceylon. It has recently been found also in 

 Macedonia. 



lEUology. — This is unknown, but probably a continuous exposure 

 to the sun and glare plays a certain role in the causation of the 

 malady. 



Symptomatology. — The affection, which in its severe type is rare, 

 is found in Europeans who have resided for many years in the tropics, 

 and who have lived an open-air life, such as planters and overseers, 

 exposing themselves to the sun for long periods of time. 



In a well-marked case (see Fig. 875) there is a festooned margin, 

 at times slightly raised, often of a vivid bright red or coppery red 

 colour, while the skin which it encircles has a peculiar whitish, 

 occasionally leucoder ma-like appearance, and may be slightly 



Fig. 875. — Dermatosis Festonata Frontalis. 



atrophied ; at times small patches of hyperpigmentation may be 

 present. There is very little or no pruritus, and sensation to the 

 touch, pain, heat, and coldjis not impaired. 



The course is extremely long, the affection slowly expanding 

 peripherally, and in a tropical climate has no tendency to spon- 

 taneous cure. 



Diagnosis. — The affection is not rarely taken for a tricophytic 

 condition, but the microscopical examination for fungi is always 

 negative, and an antimycotic treatment does not induce any im- 

 provement. From a syphilide it is differentiated by the negative 

 Wassermann and by the uselessness of salvarsan, potassium iodide, 

 and mercury ; from leprosy by the sensation being normal. 



Prognosis. — The general health of the patient is not affected, but 

 the affection runs an extremely long course, and has no tendency 

 to spontaneous cure in the tropics. It gets much better if the patient 

 goes to reside in a cold country. 



