Dermatitis

“ In doubtful cases, an observation of several weeks will always suffice to distinguish it from eczema, erythema multiforme, herpes iris and pemphigus, diseases to which it at times bears strong resemblance.
Give the prognosis of dermatitis herpetiformis.
An opinion as to the outcome of the disease should be guarded. It is exceedingly rebellious to treatment, and relapses are the rule. Exceptionally the bullous and pustular varieties prove eventually fatal. The erythematous and vesicular varieties are the most favorable. ”

“ Describe the bullous type of dermatitis herpetiformis.
The bullous expression of the disease is usually of a markedly inflammatory nature, often innumerable blebs, small and large, appearing almost continuously, and in some instances involving the greater part of the surface. The lesions arise from erythematous skin, from preëxisting vesicles or vesicular groups, or from apparently normal integument. There is a marked disposition to appear in clusters. A change of type to the erythematous or vesicular varieties is not unusual. ”

“ They who have had the fortitude to content themselves with watching the evolution of the specific dermatitis, merely protecting the skin by dusting over it a simple powder or leaving it covered with a cold compress, have certainly no worse results to tabulate than those who entertain a belief in the efficacy of the abortive treatment of the local disorder. ”

“ The crutch, or axillæ, or both, are sometimes rendered so raw and tender that the patient may be unable to walk or even to dress. The irritation and itching are usually worse at night, and may keep the patient awake for hours. Even in the absence of treatment, when the cold season comes round the dermatitis and irritation subside spontaneously. The affected parts then become dry, pigmented, and scurfy, and the fungus remains quiescent until the return of the next hot weather.
Diagnosis.— The diagnosis of mycotic dermatitis is usually easily made. ”

“ The penetration and presence of the parasites within the cutaneous structures besides often giving rise to several or more complete or imperfectly formed burrows, excite varying degrees of irritation, and in consequence the formation of vesicles, papules and pustules, accompanied with more or less intense itching. Secondarily, crusting, and at times a mild or severe grade of dermatitis, may be brought about. ”

“ However, in 8 of 217 test material combinations shown in Table 4-12, study directors indicated that skin sensitization occurred among human subjects. A few of the RIPT reports submitted in response to the 1987 Federal Register notice document responses to CCP or its components that were consistent with the induction of allergic contact dermatitis under the intensive exposures of the experimental protocols. ”

“ CCP reactions, nonreacting persons (those without a history of allergy or irritative reactions) can handle CCP without risk. Jeansson et al. 1983, 1984. During patient followup visits, the authors investigated patients who had complaints related to any type of paper and who had been referred to an occupational dermatitis clinic in Sweden from January 1974 to December 1980. Their complaints included irritation of the eyes, nose, throat, arms, face, and scalp; cold symptoms; hoarseness; sores; itching, dryness, redness, or eczema of the hands; unpleasant odor or taste; fatigue; headache ”

“ In hot, damp weather especially, the germs proliferate actively, producing, it may be, smart dermatitis. The excessive irritation thus set up leads to scratching and, very likely, from secondary bacterial invasion, to boils or small abscesses. ”

“ The majority of persons are not affected by these plants, but in many contact, or in some mere proximity to the plant, will be followed by a dermatitis, variable as to degree. The inflammation may simply be of an erythematous character with slight swelling, or, on the other hand, it may be vesicular, pustular, or bullous, with marked hyperæmia, oedema, and swelling. ”

“ Dermatitis Factitia—note the unusually uniform and regular character and arrangement of the lesions.
Dermatitis Gangrænosa.
Dermatitis Gangrænosa.
What do you understand by dermatitis gangrænosa?
Dermatitis gangrænosa (erythema gangrænosum, Raynaud's disease, spontaneous gangrene) is an exceedingly rare affection, characterized by the formation of gangrenous spots and patches. It [Pg 66] may be idiopathic or symptomatic. Some of these cases, especially in hysterical subjects, belong under the “feigned eruptions,” being self-produced. ”

“ Cases are being constantly reported by physicians, where the use of these supposedly simple vegetable hair-dyes has been followed by very serious and extensive dermatitis of the face, neck, and shoulders. ”

“ L13.1 Subcorneal pustular dermatitis Sneddon-Wilkinson disease L13.8 Other specified bullous disorders L13.9 Bullous disorder, unspecified L14 Bullous disorders in diseases classified elsewhere Code first underlying disease Dermatitis and eczema (L20-L30) Note: In this block the terms dermatitis and eczema are used synonymously and interchangeably. ”

“ Among the local causes producing the so-called artificial eczemas the preparations of mercury, sulphur, croton oil and tincture of arnica are most notable. Contact with the several varieties of the rhus plant, though usually producing a peculiar dermatitis, may in eczematous subjects provoke a genuine eczema. Heat and cold, especially the rays of the sun, are also factors to be considered, while it is well known that the disease in many instances is influenced by the seasons, being, as a rule, worse in winter than in summer. There are many subjects who suffer only in winter. ”

“ Of course radiations of brief duration would do her no permanent harm, although they would produce their effect, nevertheless. In one night the maid became extremely nervous. If she had stayed under them several nights no doubt the beginning of a dermatitis would have affected her, if not more serious trouble. A systematic application, covering weeks and months, might in the end even have led to death.
“The next day I managed, as I have said, to go over the room thoroughly with a vacuum cleaner—a new one of my own which I had bought myself. ”

“ SYMPTOMS.—Eczema, known popularly as tetter, is the most important and the commonest of the diseases of the skin. It may be defined as an inflammatory, non-contagious disease of the skin, characterized in the beginning by erythema, papules, vesicles or pustules, or a combination of these lesions, pursuing an acute or chronic course, accompanied by infiltration and itching, terminating either in discharge with the formation of crusts, in absorption, or in desquamation. The disease is multiform in character, and is capable of manifesting itself in a great variety of forms ”

“ Diseases of the skin tend to manifest themselves in certain parts of the body; i.e. certain diseases exert a selective influence on the sites of their eruption. Symmetry is characteristic of eczema, psoriasis, drug rashes and the eruptions of specific fevers, while others, such as herpes zoster, ring-worm, tertiary syphilis and new growths, tend to be asymmetrical. Eczema selects the flexor aspect of the limbs and the neighbourhood of folds of skin and opposed surfaces, while psoriasis favours the extensor surfaces and the outer side of the elbows and knees. ”

“ Eczematous symptoms may be superadded. In severe cases the entire extensor surfaces of the legs and arms, and in some instances the trunk also, are invaded. It is worse in the winter season. [Pg 119]
What is known in regard to etiology and pathology?
It is a disease of the ill-fed and neglected, usually developing in early childhood, and persisting throughout life. It is extremely rare, even in its milder types, in this country. Clinically and pathologically it bears some resemblance to papular eczema.
Give the prognosis and treatment of prurigo. ”

“ No; in those of great cutaneous irritability, especially in children, the skin being more tender, the type of the eruption is usually much more inflammatory. In those predisposed a true eczema may arise, and then, in addition to the characteristic lesions of scabies, eczematous symptoms are superadded; in long-persistent cases, indeed, the burrows and other consequent lesions may be more or less completely masked by the eczematous inflammation, and the true nature of the disease be greatly obscured. ”

“ Erythematous eczema (eczema erythematosum) begins as one or more small or large, irregularly outlined hyperæmic macules or patches, with or without slight or marked swelling, and with more or less itching or burning. At first it may be ill-defined, but it tends to spread and its features to become more pronounced. It may be limited to a certain region, or it may be more or less general. When fully developed, the skin is harsh and dry, of a mottled, reddish or violaceous color, thickened, infiltrated and usually slightly scaly, with, at times, a tendency toward the formation of oozing areas. ”

“ You also observe that I give them a dose and tell them to return in a week or ten days. When they return they often exhibit a splendid crop of symptoms, and I experience no trouble then in finding the remedy. These cases usually have a history of suppressed eruption. At some time in their lives the itch, or eczema, or some other skin trouble has been driven into their system by external medicaments in the form of ointments, washes, etc. Lifelong ailments, over which the old school have no control, are the result. A large percentage of chronic diseases are due to this cause alone. ”

“ Frequently the whole body is covered with patches of eczema, the secretions are arrested, and, where the scales fall off, the skin is left dry and feverish.
Eczema has no symptoms proper, since the morbid feelings are due to constitutional debility, of which eczema is the result. The signs of eczema are redness, heat, an itching or smarting sensation, the formation of pimples or vesicles, exudation, incrustation, the separation of the cuticle into scales and a gradual thickening of the skin. ”

“ Eczema, a common skin disease, which may be either chronic or acute; develops in a red rash of tiny vesicles, which usually burst and produce a characteristic scab; is not contagious, and leaves no scar. ”

“ In psoriasis the epidermis separates in flakes at various spots which have not been subjected to pressure, and to cure it ointment Inflammation.containing tar or other products of the dry distillation of wood is employed. When the true skin is inflamed various appearances may arise, according to the intensity and extent of the inflammation, and the eruption may be papular, vesicular, pustular, tubercular, bulbous or ulcerative. To lessen irritation the skin is protected by dusting powders, such as oxide of zinc, starch, fuller’s earth, &c., or by ointments. ”

“ I found the Down begin to make my hand itch, and in some places to smart again, much like the stinging of a Flea or Gnat, and this continued a pretty while, so that by degrees I found my skin to be swell'd with little red pustules, and to look as if it had been itchie. But suffering it without rubbing or scratching, the itching tickling pain quickly grew languid, and within an hour I felt nothing at all, and the little protuberancies were vanish'd. ”

“ The cure which is sought for may either be symptomatic or radical. Various morbid conditions of the body generally may give rise to different symptoms. Thus a gouty condition may manifest itself in one man as eczema of the skin, giving rise to redness and intense itching; in another as neuralgia, causing most severe pain; in a third as bronchitis, producing a distressing cough; in a fourth as dyspepsia, giving rise to flatulence and intestinal disturbance; and in a fifth as inflammation of the great toe, accompanied by redness, swelling and pain. ”

“ SANDHOLM'S SKIN LOTION is a clear liquid used externally. Eradicates all
skin and scalp trouble by absorbing the germ--returns the skin to normal
condition. IT HAS NO EQUAL for
Salt rheum, Eczema, Rash, Tetter (Herps) , Scald head, Milk scald, Plant
poisoning, Hives, Mosquito bites, Small burns or scratches, Barbers'
Itch, Parasitic diseases, Scaly or scabby eruptions of the skin, Itching
piles, Acne, Psoriasis, Pimples, Blackheads, Cracked hands and lips,
etc. A perfect antiseptic after shaving.
WHAT IS MORE DESIRABLE THAN A CLEAR, HEALTHY SKIN? ”

“ The skin, partly for this reason, and partly because it shares in the general disturbance of nutrition, becomes dry, harsh, and scaly; after a time the face, and especially the nose and neighboring parts, assumes in many instances a violaceous hue, the minute superficial cutaneous veins are enlarged, and acne is common. The resulting appearance is almost characteristic of the habits of the individual. Alcoholic subjects frequently suffer from pruritis, urticaria, and eczema. ”

“ If the disease continues longer it is because of the unnecessary amount of fat that the child has.
Treatment.—Eczema is a notoriously tedious disease. There is very little tendency for it to improve, if left to itself. The age, the severity, and just how much you can rely upon the mother, or nurse, faithfully to carry out directions—upon these its cure depends. At best, the treatment may have to be carried out for months. If the eczema is accompanied with constipation and indigestion in infancy, very little can be done with the eczema until these conditions are removed. ”

“ Symptoms: skin thickens with papules, vesicles or pustules, scurf, crusts, depilation, surface glossy, abraded, scratched, raw, rough, fœtid, itching, emaciation, exhaustion. Chronic eczema of the back. Fat, old, gluttons. Symptoms: circumscribed patches on back, loins, quarters, tail, intense itching, skin thickened, cracked, raw, encrusted, black, folded, rigid, fœtid, hair broken, erect, shedding. Very inveterate. Chronic eczema of elbow and hock. Causes: friction on summits of prominent bones, filth, infection, predisposition. ”