The conditions which modify the characters of inflammations of the skin, and their influence on treatment : being the Lettsonian lectures at the Medical Society of London, on February 16, March 2 and 16, 1903 / by H. Radcliffe-Crocker.

  • Henry Radcliffe Crocker
Date:
1904
Catalogue details

Licence: In copyright

Credit: The conditions which modify the characters of inflammations of the skin, and their influence on treatment : being the Lettsonian lectures at the Medical Society of London, on February 16, March 2 and 16, 1903 / by H. Radcliffe-Crocker. Source: Wellcome Collection.

    38/64 page 34
    eruption, the lesions nearly always remain discrete, and this is an important diagnostic point. Unless there are secondary pus inocu- lation sores, the. eruption is particularly dry and rough, and suggests the use of ointments, but these, in my experience, invariably increase the irritation, and the patients tell you flatly that they cannot use them. Astringent drying lotions, especially the organic silver salts, give the most relief, and enable the patient in a great measure to abstain from scratching, and then improvement occurs, unless a fresh outbreak is produced by a direct exposure to the sun or to a bitterly cold wind. A precisely similar eruption may occur in winter in some patients, in these cases, the cold winds being the greatest provocative, and the sun’s rays having less irritant action. The winter cases are much less common than the summer ones, but both the summer and winter cases continue to be liable to recur- rences according to their special peculiarities year after year, or several times a year, until the patients reach adult age, when the liability gradually ceases, and it seldom persists after the age of 25 years. The skin from the repeated inflammation is left rather thickened, pallid, and sometimes superficially scarred from the repeated excoriations. Other forms of this summer eruption are papulo-erythematous, papulo-vesicular, and vesiculo-pustular, but the most common form consists of pale red conical papules with or without a little clear fluid at the apex, which dries up and shells off, leaving minute shalloAv scars which in the course of time impart a mottled look to the whole face. The distribution, though always predominating on the exposed parts, is less limited than the summer prurigo type. This does not exhaust the varieties in form of these eruptions, but the general behaviour being the same in all, enables them to be recognised in spite of their different morphology. The summer disease first described by Bazin is known by the name of hyclroa vacciniformis seu aestivalis. It is fortunately rare, as it produces great and permanent disfigurement and even mutila- tion of the face and ears, so that in the final cicatricial stage the patient looks as if he had had a severe lupus, as the nostrils and ears are partially destroyed; there may also be extensive scarring of other parts of the face. This disease generally begins in the first three years of life, and nearly all its subjects have their worst attacks almost exclusively in the summer from the direct effect of the sun, but artificial heat and cold winds will sometimes excite
    digitised image 1
    digitised image 2
    digitised image 3