A manual of the practice of medicine / by Frederick Taylor.

Taylor, Frederick, Sir.

Date:: 1891

Credit: A manual of the practice of medicine / by Frederick Taylor. Source: Wellcome Collection.

868/966 page 848

$Lichen Circinatus or Circumscriptus. The position of this disorder is still somewhat uncertain. It is a fairly common and harmless eruption, and consists of small flat dusky red papules, combining to produce circular patches a quarter or three-eighths of an inch in diameter, which may clear in the centre, and ultimately form rings of a larger size. By running together they result in scalloped and gyrate figures. The papules are often covered with a yellowish-brown scale. They occur almost exclusively over the sternum and on the back between the shoulders, but may extend from the middle line in front over the pectoral regions. The eruption itches slightly, but otherwise causes little discomfort, and may be only noticed when the patient consults his doctor for some other complaint. The skin is often greasy, and the patients are found to wear tlannel shirts or vests. It is more frequent in men than in women. The circular outline has suggested a parasitic origin, but no fungus has been found. Recently it has been described as sehorrhoea corporis, in spite of the inflammatory lesion obvious in the papule. The situation, the annular shape, and the frequent yellowish tinge are characteristic. Only if very extensively developed in a gyrate form could it be susj^ected of having a syphilitic origin. Treatment.—Tar or creasote ointment, and glycerine of borax or thymol, cure it speedily ; but it readily returns if the local con- ditions are not altered by frequent washing, and suitable changes of underclothing. Other Skin Diseases Described as Lichen. L. simplex and L. agrius are papular forms of eczema; L. lividus is purpura round the hair-follicles; L. urticatus is urticaria in children ; L. jnlaris is now called keratosis pilaris ; but Dr. Crocker describes under the title Lichen pilaris a very rare disease, the Lichen spinulosus of Devergie, an inflammatory disease of the hair- follicles, in wiiich a spiny epidermic peg occupies the centre of the papule. It is to be treated by alkaline baths, and subsequent friction with soap liniment. PRURIGO. This is a papular disease accompanied with severe itching {prurio, to itch). It must be distinguished from pruritus, which means simply the sensation of itching, and not structural change. Thus, we have pruritus in prurigo itself, but also in eczema, in jaundice, and in other conditions. One disease that is often ^described as prurigo (P. senilis, P. pedicularis, Phtheiriasis) is$

A manual of the practice of medicine / by Frederick Taylor.

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