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.

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    superficial dermatitis, which has reached or will reach the stage of exudation. 1. The most numerous and characteristic group of cases, those which may be called typical eczema. The patients may be of either sex and of any age, but are more often young or middle aged adults than children or aged persons. The eruption begins as a papular erythema, but the papules rapidly become small, thin walled, superficial vesicles, which so readily burst under friction that (although almost always present if looked for at the right time) they are in most cases practically absent. A weeping surface thus forms, over which the traces of vesicles may often be discerned (etat ponctue). As the profuse secretion subsides, thin yellowish crusts appear, the dry surface becomes covered with small dingy scales, the redness and infiltration gradually subside, and the skin returns to its normal condition. Only rarely is accumulation of pigment observed, and never formation of scars. The course of the disease is more or less acute at the outset, but soon becomes chronic, and is apt to return after cure. The distribution is characteristically limited to the thin skin of the flexor surfaces, the favourite places being the bend of the elbows, the hams, and the back of the ears; next, the face, neck, arms and hands, axillae and groins, abdomen and genitals, thighs and legs ; while this form of eczema is rare on the scalp, buttocks and feet. Always more or less symmetrical, it is often as exactly so as psoriasis. Lastly, it is almost always accompanied with itching as well as smarting. With respect to the pathology of this commonest and most characteristic form of eczema, I confess that I am quite unable to recognise its association with any other disease, or with any supposed diathesis, constitution, dyscrasia, or temperament. It has, I believe, nothing to do either with rheumatism (i.e. multiple synovitis with pyrexia) or with gout (arthritis with deposits of urates of soda), or with scrofula (caseous infiltration of lymph glands), or with rickets, or with anaemia, or with gastric or uterine disturbance. No doubt we see cases of eczema in conjunction with each of these conditions; if this never happened, we should have to investigate the reason of such mutual exclusion; but I believe that it is essentially a disease of the skin and nothing else. As to the blood espe-