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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    nmst not mean vaguely ill-health, but caseous degeneration of lymph glands. Until, therefore, we learn better, we must consider that psoriasis is not due to a supposed arthritic, herpetic, or dartrous diathesis, that it is not a manifestation of gout, and that it has no more to do with scrofula than with syphilis. Again, we cannot trace psoriasis, as we so often can eczema, to a local irritant. It cannot be excited at will, it is not pro- duced by sun or cold, or sweat or friction, or mustard, or venous congestion. It is scarcely an inflammation, certainly not an exudation in the sense of Rokitansky and Hughes Bennett. But the histological appearances are decisive of its being a true chronic inflammation of the Malpighian layer and sub- jacent papillae, with hypertrophy of the latter and subsequent atrophy of the former.1 And occasionally we see the early stages of psoriasis, like those of syphilodermia, showing the ordinary signs of inflammation. Case.—A young man came to me with a bright rose rash, which had appeared the day before in minute patches over his chest. It looked like early syphilitic roseola, but there were no other secondary symptoms and no evidence of infection. There was slight local heat and general malaise. Two days later he came again, perfectly well in himself, with the rash changed into a papular form and several of the papules covered with small white scales. In a week or ten days an ordinary Psoriasis guttata had developed, which soon yielded to remedies and has not returned. The early origin of psoriasis, its almost constant distribution, its frequent repetitions, and its appearance in different members of the same family, point to its being an inherent and not an accidental vice of the skin. Though most cases of psoriasis appear to be free from here- ditary influence, we sometimes meet with such marked instances that we must admit it among hereditary diseases. In this respect it resembles carcinoma and rheumatism. I need scarcely refer to a lately propounded hypothesis that psoriasis depends upon the presence of a fungus, for it is 1 See the figures by Neumann, and an interesting paper by Dr. Thin, in the ‘British Medical Journal’ for July, 1881. 4