Observations on the various forms of superficial dermatitis : particularly erythema, eczema, psoriasis, lichen, and pityriasis rubra with cases / by P.H. Pye-Smith.

  • Pye-Smith, Philip Henry, 1840-1914.
Date:
[1881?]
Catalogue details

Licence: Public Domain Mark

Credit: Observations on the various forms of superficial dermatitis : particularly erythema, eczema, psoriasis, lichen, and pityriasis rubra with cases / by P.H. Pye-Smith. Source: Wellcome Collection.

    16/88 (page 12)
    Crust a lactea of older writers, Willards Porrigo larvalis and also P. favosa, the Impetigo larvalis of Bateman, Teigne muqueuse, Eczema impetigo. It rarely affects infants before the scalp is well covered with hair, and still more rarely adults, although we have lately had several cases of typical impetigo of the scalp in both men and women. The exudation is not the characteristic albuminous secretion of eczema, but is purulent, forming thick massive crusts. The eruption is in patches ; it is accompanied by com- paratively little itching; instead of affecting the ears, limbs, and bend of the joints, it is at first confined to the scalp or face, especially the lips and nose, and when it spreads elsewhere appears to do so by direct inoculation. The three conditions to be distinguished from this true idiopathic pustular derma- titis, are, (1) the pustular inflammation of the occiput caused by pediculi, almost exclusively confined to children, and readily cured by removing the irritant; (2) scabies, which may be little developed on the feet or hands or nates, or may even have been cured and yet has by inoculation of its pus produced “ impe- tigo ” of the face or scalp of the child; (3) true ringworm, either obscured by the inflammation it produces, or more often concealed or even supplanted by the severity of the applications which have been used to destroy the fungus. That impetigo of the scalp and face in children is really a pus- tular form of eczema is proved, by an ordinary eczema of the scalp or face in an infant becoming pustular and crusted as the patient grows older, by impetigo in a child assuming the characters of common eczema when it recurs, and by impetigo of the scalp being associated in the same patient with vesicular or weeping eczema of other parts. We may connect its pecularities, first, with the age of the patient. The skin of children appears to be more prone to suppurate than that of adults. Not only eczema but scabies is more often pustular with them ; and the scattered pustules of doubtful origin which go by the names of ecthyma and impetigo sparsa are almost confined to children. Secondly, the presence of large and numerous sebaceous glands seems to lead to suppuration, when the surface is inflamed. We know how readily pustules form within the nostrils and in the eyelids (hordeolum), over the shoulders, on the face (acne), and in the beard (sycosis). When eczema spreads to the head in adults