Skin eruption

“ The location of the eruption in this disease depends, to a great extent upon the character of the clothing which the patient wears, and differs in the case of men, women, and children. The excoriations about the breasts of women and upon the genitals of men and boys are due to the ease with which these parts can be scratched at night, while in young children who wear long, close-fitting night dresses the wrists and ankles are most likely to be the seat of the eruption. ”

“ On December 7 an eruption appeared. On December 8 the patient presented the following appearance: Face uniformly red, or of a dusky hue, and swollen; on close examination a faintly papular condition was apparent. Over chest, abdomen, and extremities was found a profuse papular eruption, of a very dusky or violet-colored hue. On the abdomen some of the papules had coalesced. Papules were noticeable on the hands and feet, particularly on the palms. On the inner surface of the thighs the entire skin presented the appearance of a scarlatinous eruption, although darker in color. ”

“ The progress of variolous fever has been divided into four stages, that preceding the eruption; the eruption; the suppuration; and the exsiccation of the pustules. The first visible effects of the contagion and fever are nausea, vomiting, soreness at the stomach, drowsiness: before the eruption infants are prone to startings, and some even to epileptic fits; adults to sweats. The second stage of eruption is, from three to four days, from the first attack, of small red spots or pimples on the skin, resembling flea-bites, in number and quantity extremely various ”

“ If the eruption is very severe, fever will be of corresponding violence, and lighter or wanting when the eruption is mild. This fever rarely lasts more than twenty-four hours, from which time the patient rapidly recovers.
In the Confluent variety, all the symptoms are more violent, the fever continuing after the eruption begins. The pustules burst early, and run into each other, covering nearly or quite the whole skin; the surface swells and turns black or dark brown, the lungs are more or less irritated, producing cough, and not unfrequently the stomach is nauseated, and vomiting ensues. ”

“ Within these areas there were islets of paler and shiny skin, which showed superficial atrophy. A small area in each patch was covered with a crust which was difficult to remove, and when detached showed little tags and prominences on the under surface. The appearance of the eruption had not materially altered since the patient was first seen fourteen months ago.
All the members present agreed with the diagnosis of the exhibitor.
(2) A woman, aged 38 years, suffering from a curious eruption associated with obscure nerve symptoms. ”

“ He is free of any eruption at the present time, but the upper part of his body and especially his arms are covered with a large amount of brown spots on the skin where the eruptions have completely died away, but I think that with each succeeding year, as he grows stronger, the effect will entirely disappear, with the exception of the brown spots on the skin, which I suppose will always remain and for which there can be no remedy. ”

“ The eruption may be partly due to wool in the underwear. Change it for muslin or linen shirts, and have the knitted belly-band over that, not next to the skin.
Eczema is a far more serious eruption. It is [Pg 195] marked by inflammation and great itching. The skin seems to thicken; it becomes moist and shows fissures from which a serum oozes and forms crusts. It is most commonly found on the face and scalp, but it may also be found in the folds of the skin at various parts of the baby’s anatomy. It may spread or it may be confined to only a small area. ”

“ A gentle sweat, or moisture on the skin, greatly promotes the eruption; but, when the skin is dry, the eruption is both more painful and dangerous.
Sometimes this is a primary disease; but it is much oftener only a symptom of some other malady, as the small-pox, measles, ardent, putrid, or nervous fever, &c. In all these cases it is generally the effect of too hot a regimen or medicines.
The miliary fever chiefly attacks the idle and the phlegmatic, or persons of a relaxed habit. The young and the aged are more liable to it than those in the vigour and prime of life. ”

“ Affections of the Skin.—Although all types of skin affection are met with in the inherited disease, the most important is a papular eruption, the papules being of large size, with a smooth shining top and of a reddish-brown colour. It affects chiefly the buttocks and thighs, the genitals, and other parts which are constantly moist. It is necessary to distinguish this specific eruption from a form of eczema which occurs in these situations in non-syphilitic children, the points that characterise the syphilitic condition being the infiltration of the skin and the coppery colour of the eruption. ”

“ The small swellings or eruptions, when squeezed, very often yield blood; in other respects the patient is generally in good health, saving the pain the ulcers give him, and the still greater uneasiness of mind which he suffers from the spoiling of the smoothness of his skin; for all the nations in Africa within the tropics are wonderfully affected at the smallest eruption or roughness of the skin. A black of Sennaar will hide himself in the house where dark, and is not to be seen by his friends, if he should have two or three pimples on any part of his body. ”

“ The premonitory chill is violent; the cephalic and lumbar pains are excruciating; the fever, rising to a high grade, 106° to 110° F., with few and slight remissions, scarcely subsides, if at all, with the appearance of the eruption, the latter developing early, and, to borrow an expression from syphilographers, exploding with violence over large areas of the surface of the body. The initial lesions of the exanthem are dense and deeply-set papules, so closely coherent even at this moment that they scarcely leave between them interspaces of sound skin. ”

“ Myrtle remarks that he has had several cases where mauve-dyed articles of clothing have produced great local irritation, which in one or two cases has proved not only painful, but most difficult of cure. Neckties and socks have furnished obstinate forms of an eruption of an herpetic character, the base of each vesicle being painful and greatly inflamed. The eruption has, in appearance and nature, resembled shingles more than anything else, although it is, as far as my observation goes, a distinct form of skin disease. ”

“ A gentleman who is subject to a scorbutic eruption in his face, for which he has used a variety of remedies with no very beneficial effect, has lately applied the fumes of chalk and oil of vitriol to the parts affected. The operation occasions great itching and pricking in the skin, and some degree of drowsiness, but evidently abates the serous discharge, and diminishes the eruption. This patient has several symptoms which indicate a genuine scorbutic Diathesis; and it is probable that fixed air, taken internally, would be an useful medicine in this case. ”

“ The parasite seeks preferably tender and protected situations, as between the fingers, on the wrists, especially the flexor surface, in the folds of the axilla, on the abdomen, about the anal fissure, about the genitalia, and in females also about the nipples, and hence the eruption is most abundant about these regions. The inside of the thighs and the feet are also attacked, as, indeed, may be almost every portion of the body. The scalp and face are not involved ”

“ After this crisis has occurred, however, in ninety-nine per cent of all cases it is comparatively plain sailing; the throat is still sore and troublesome, the skin itches and tickles, and the eyes smart, but the little patient steadily [Pg 259] improves day by day. Anywhere from three to five days after the break in the fever the skin begins to get rough and scaly, and gradually peels off, until in some cases the entire coating of the body is shed, having been killed, as it were, by the violence of the eruption. ”

“ As the attack advances the pulse gradually or rapidly rises above the normal rate, and sometimes becomes very frequent, and the skin, although it grows warmer, does not often acquire the temperature observed in idiopathic fevers or sustain it as they do. In many cases eruptions appear upon the skin. During some epidemics the only one observed is herpes labialis; in others the eruption resembles roseola, measles, or the mulberry rash of typhus, or from the first it consists of petechiæ, vibices, or extensive ecchymoses. ”

“ Torpor pedum in eruptione variolarum. At the commencement of the eruption of the small-pox, when the face and breast of children are very hot, their extremities are frequently cold. This I ascribe to sensitive association between the different parts of the skin; whence when a part acts too violently, the other part is liable to act too weakly; and the skin of the face being affected first in the eruption of the small-pox, the skin of the feet becomes cold in consequence by reverse sympathy. ”

“ The first thing to be done is to bring out the rash, which is quickly done, by flushing the colon, followed by a wet sheet pack, as in scarlet fever. When the eruption is out, nothing is needed but to keep the colon clean, and wash down daily with tepid water. In all eruptive diseases guard against taking cold—for a cold closes the pores of the skin, shutting up Nature's vent through which she is expelling the disease germs. ”

“ As soon as this Eruption appears, if the Distemper is of a gentle Kind and Disposition, the Fever almost entirely vanishes: the Patient continues to sweat a little, or transpire; the Number of Eruptions increases, others coming out on the Back, the Sides, the Belly, the Thighs, the Legs, and the Feet. Sometimes they are pushed out very numerously even to the Soles of the Feet; where, as they increase in Size, they often excite very sharp Pain, by Reason of the great Thickness and Hardness of the Skin in these Parts. ”

“ If choking is threatened, give an emetic of mustard, one teaspoonful, and warm water, half a pint.
PIMPLES; BLACKHEADS (Acne) .—This eruption is situated chiefly on the face, but often on the back, shoulders, and chest as well. It is a disorder which is seen mostly in young men and women at about the age of puberty. It consists of conical elevations of the skin, from a pin head to a pea in size, often reddened and tender on pressure, and having a tendency to form matter or pus, as shown by a yellow spot in the center of the pimple. ”

“ The appearance of the eruption is that of red or scarlet papulæ, presenting to the touch a sensible resistance, but not much raised, and without roughness or hardness. These papulæ, becoming more and more defined and elevated, [Pg 32] are after a day or two converted into vesicles, with small elevated centres or bodies of a yellowish-white, and more diffused red and somewhat hard bases or margins. The redness extending as the eruption becomes copious, converts the skin, especially of the face, neck, and hands, into a red ground, from which project, in relief, the whitish vesicles. ”

“ Describe the symptoms of erythema nodosum.
The eruption makes its appearance suddenly, and is usually ushered in with febrile disturbance, gastric uneasiness, malaise, and rheumatic pains and swelling about the joints. The lesions vary in size from a cherry to a hen's egg, are rounded or ovalish, tender and painful, have a glistening and tense look, and are of a bright red, erysipelatous color which merges gradually into the sound skin. ”

“ A prurient eruption formed in a circle, affecting children, and would seem to be the work of insects, according to the theory of Linnæus, who ascribes the itch and dysentery to microscopic animalcula. These animalcula are probably the effect, and not the cause, of these eruptions; as they are to be seen in all putrescent animal fluids. The annular propagation of the ring-worm, and its continuing to enlarge its periphery, is well accounted for by the acrimony of the ichor or saline fluid eroding the skin in its vicinity. ”

“ The eruption on the elbows rarely occurs until the patient takes to his bed and is probably incident to irritation over olecranon. Sandwith states that the skin lesions in Egypt are more widespread than those seen in Italy. ”

“ Some trifling pillage by this disease is noticed in the London bills. To adults it is most hostile. The symptoms are, more or less fever; superficial inflammation of some portion of the skin and cuticular membrane, with pain, tumefaction,{154} burning heat, redness, and pruriency, like that from nettles; and variously, in different persons, assailing the face, the neck, the trunk, or one of the extremities: the eruption seldom appears until after the commencement of the febrile commotion ”

“ When depressions of the skin, as the folds of the nates, are affected, a scaly eruption does not take place, but soft and moist elevations arise, discharging a whitish matter, varying in form and size, and accordingly receiving various appellations, as condylomata, fici, or marisci. ”

“ Eruption filling on limbs and trunk.
17th. Pulse strong and frequent; skin hot; tongue moist and loaded. Pustules scabbing on face. Not yet entirely filled on limbs, where they are in clusters with inflamed bases.
18th. Pustules full and matured on limbs. Running into each other in places. Tongue dry, brown, and furred in centre, yellow and loaded at sides. Pulse quick and frequent. Lies easy.
19th. Blebs formed on arms; pustules running into each other, beginning to shrink; matter oozing out. Tongue covered with a dark crust. Pulse quick and frequent. Erysipelas of eyelids and ophthalmia. ”