2272 



COSMOPOLITAN SKIN DISEASES 



ACNE VULGARIS— ACNE ROSACEA— ACNE VARIOLIFORMIS— 

 ACNE CHELOID. 



Acne vulgaris and Comedos are extremely common in all races. 

 Both types of acne — Acne indurata and Acne papulosa et pustulosa — 



are observed. The treatment, which is as difficult in the tropics as in 

 temperate zones, is based on the use of medicated soaps and sulphur 

 or ichthyol lotions or ointments. The vaccine treatment may 

 occasionally give good results. 



Acne rosacea is, in our experience, comparatively rare in the 

 tropics, though we have seen cases in all races. True rhinophyma 

 we have also observed. 



Acne Varioliformis.- — This, in our experience, is as frequent in 

 the tropics as in temperate zones, and may be found in all races. 

 The regions of the body more commonly affected are the fore- 

 head, temples, the front of the sternum, and the interscapular 

 region. 



Acne cheloid is very common, especially among native races. 

 The back of the neck is generally affected. Cases of Acnitis and 

 Folliclis are occasionally seen. These are probably tuberculides. 



HYPERIDROSIS AND BROMIDROSIS. 



These conditions are, for climatic reasons, very common in the 

 tropics, and have already been considered (see p. 2222). The 

 treatment may be very difficult. Naphthol or salicylic alcoholic 

 lotions (i per cent.), followed by a salicylic, boric, or tannoform 

 powder, are useful. If there is much inflammation of the skin, no 

 alcoholic lotions should be used, but simply water solutions of boric 

 acid (2 per cent.) carbolic acid (J per cent.), permanganate of potas- 

 sium (i in 5,000), and occasionally hydrargyrum perchloride (i in 

 2,000 or 4,000), after which a salicylic or boric powder is applied. 

 The same powder should be sprinkled on the socks and shoes and 

 undergarments. Internal treatment by sulphur, acid drinks, 

 etc., is not of much use. Belladonna and atropin will stop the 

 secretion for a time, but they must be pushed till unpleasant 

 symptoms occur. We have seen a case of chromidrosis of the axilla 

 in a native boy due to the presence of a bacillus closely allied to the 

 Bacillus prodigiosus, and another due to a red-pigment -producing 

 coccus. 



Granulosis rubra nasi is occasionally seen in half-caste and 

 European children. 



LICHEN PLANUS— LICHEN SPINULOSUS— PITYRIASIS RUBRA 

 PILARIS— PARAKERATOSIS VARIEGATA— POROKERATOSIS. 



Lichen planus is common in the tropics among Europeans and 

 natives of the various races. In very dark-skinned natives the 

 diagnosis may be difficult to the medical man used to seeing skin 



