symptoms of erythema

TOXIC ERYTHEMA

Diagnosis

From the acute specific fevers. This may be difficult, and often depends upon the mildness of constitutional symptoms, absence of coryza, tonsillitis, Koplik's spots, adenitis, or other characteristics of the fever in question. Drug eruptions must always be considered. Pityriasis rose and secondary syphilis must not be forgotten as possibilities in a macular erythema.

Treatment

The cause if discovered must, be removed, but in many cases no cause is ever found. If any external application is required calamine lotion on a dusting powder is usually sufficient.

skin disease ichthyosis

Diagnosis

The symmetrical affection of both hands and feet, the history, and the absence of eruptions elsewhere on the skin should make it easy to distinguish this disease from hyperkeratosis due to hard work, from arsenical hyperkeratosis and from hyperkeratosis due to eczema psoriasis, or pityriasis rubra pilaris.

Prognosis. The condition is incurable.

Treatment

This consists of the regular use of emollient Ointments as detailed in the treatment of ichthyosis.

malignant melanoma of the skin

About 50% of these tumours arise  from a pre-existing junction naevus and 50% from apparently normal skin. They do not, occur before puberty. Signs of commencing malignancy in a pre-existent mole are sudden spread, especially with a halo of pigmentation outside the lesion, darkening in colour, irritation or friability. A malignant melanoma arising in normal skin is usually a glistening, jeb black colour, but can occasionally be skin coloured.

Treatment

Junction naevi should either be left alone or completely excised. Treatment is indicated either for cossmetic reasons or if a lesion is subjected to constant, irritation, for instance when it is on the hands or feet or on the trunk under a belt, braces or other constriction. Dermal naevi may be treated by any means. small ones may be removed by electrolysis, electrocautery or excision. Raised non-pigmented moles can be satisfactorily dealt with by slicing them off level with the skin under a local anaesthetic, the bleeding being stopped by pressure or touching with the electrocautery. Hairy moles should be excised and the defect repaired by graft.

Senile lentogo should not be treated unless malignancy super venes and then no more than local excision is necessary.

leg diseases

The bite is visible as a minute red macule which irritates,greatly. The linear scratch marks which patients with pediculosis corporis make on their shoulders with their nails are very characteristic and almost enough for a diagnosis. Pediculosis corporis is quite common in elderly people living in hostels or under crowded conditions, and scratch marks on the shoulders in such patients should always lead to a careful search for parasites or ova on the underclothes. Pediculosis corporis, and the scratching to which it gives rise, cause after a time thickening and pigmentation of the skin, the so-called Vagabond's Disease.

 Treatment

 A hot bath followed by thorough powdering  of the underclothing with a l0% D.D.T. powder will rid the patient of lice. The impregnation of underclothing with l-2% by weight of D.D.T. will keep the wearer free from body lice though not from crab lice, for about one month in spite of weekly laundering. A powder consisting of l0% of D.D.T. in an inert diluent proved invaluable in the army and in controlling louse infestation in civil populations during the late war, in the Naples typhus epidemic in 1944. The powder is blown into the clothes with a blower at five sites without undressing the patient.

wart skin disease

These result from a localized hypertrophy of the basal cell layer of the epidermis. They are not caused by virus, but are included here for convenience. They are flat, brown or black excrescences 1/ 2 to 2 cms. in diameter, raised only slightly above the general surface, which are common on the trunk of patients aged forty-five or over though they may occur earlier. They may also appear on the temples or scalp. The surface is horny, and if pulled off leaves hypertrophied papillae projecting. They have to be distinguished from pigmented moles. Seborrhoeic warts are usually of shorter duration, and are present in greater numbers than pigmented moles; they give the appearance of being on rather than in the skin, and the way the surface can sometimes be pulled off is also a help in diagnosis. On the temples they must be distinguished from solar keratoses which may become malignant. Seborrhoeic warts never do this, Usually they cause no symptoms but occasionally they give rise to serve itching.

Treatment

Painting with pure carbolic acid usually causes them to fall off in a week or ten days. If this fails they may be frozen, or they may be curetted off under local anaesthesia.

seborrheic skin disease

A particular pattern of eczema may occur in association with the seborrhoeic eruptions  or may alternate with them. The condition is markedly erythematous and exudative and leads to profuse greasy flaky crusting. It frequently begins on the scalp, where the exudation may be so profuse as to soak the patient's pillow at night and run down his face and neck during the day. It may spread to the forehead and temples and down the neck behind the ears. Occasionally the condition may be localised to the creases behind the ears, the eyebrows or the upper eyelids. Alternately, the malady may affect, the flexures, notably those of the trunk such as the axillae, the fold beneath the breasts or across an obese abdomen, the umbilicus, groin or natal cleft. In severe cases, sheets of red, glazed, oozing and crusting eczema may spread widely on the trunk and even on to the limbs.

psoriasis skin disease

 

The exact nosological position of this condition remains obscure. However, since it has certain of the features of eczema and is not infrequently mistaken for it, it is considered here. It occurs equally in the two sexes and is commonest between the ages of 40 and 50. Although no more a variant of psoriasis than of eczema, it appears four times more frequently in psoriatics and this explains its title. It is characterized by flat, yellow sterile pustules occurring under the horny layer of the epidermis of the palms and soles. The pustules may occur symmetrically on both hands, commonly on the thenar or hypothenar eminences, or on both feet, commonly under the insteps. Or they may appear on one hand or one foot only or on all four extremeties. They are accompanied by slight or moderate discomfort or irritation. The pustules dry up, turn brown and then exfoliate, while fresh ones continually appear. It is one of the most intractable of all skin diseases.

Diagnosis

It must be distinguished from secondarily infected eczema or dermatitis. In such cases the pustules are usually much larger and more prominent and there is much more inflammation, pain and disability. Culture from the pustules will grow an infecting organism, usually a staphylococcus. These characteristics apply equally to

Secondarily infected vesicular ringworm of the soles, but here fungus can also be seen in the roofs of the lesions on microscopic examination.