Essentials of Diseases of the Skin Part 49

What is the pathology of xanthoma?

It is a benign, connective-tissue new growth, with concomitant or subsequent, but usually partial, fatty degeneration.

Give the prognosis of xanthoma.

The condition is persistent, and usually irresponsive to all treatment save destructive or operative measures.

What is the treatment of xanthoma?

Treatment consists, in suitable cases, of excision; in some instances, electrolysis is serviceable. Applications of trichloracetic acid cautiously made are sometimes of value. In that form of general xanthoma due to diabetes the treatment of this latter condition will materially and sometimes completely remove the eruption.

Myoma.

(_Synonyms:_ Myoma Cutis; Dermatomyoma; Liomyoma Cutis.)

Describe myoma.

The disease is rare, and consists usually of one or several (exceptionally numerous), variously-sized tumors of the skin, made up of smooth muscular fibres. They are flat, rounded, oval or pedunculated, and have a smooth surface and a pale-red color; as a rule, they are painless.

The growth is benign, and consists essentially of a new formation of unstriped muscular fibres; but it may also be composed largely of connective tissue (_fibromyoma_); or it may contain an abundance of bloodvessels (_myoma telangiectodes_, _angiomyoma_); or there may be lymphatic involvement (_lymphangiomyoma_).

Angioma.

(_Synonyms:_ Naevus Vasculosus; Naevus Sanguineus.)

Give a definition of angioma.

Angioma is a congenital hypertrophy of the vascular tissues of the corium and subcutaneous tissue. Exceptionally it makes its appearance a few weeks or a month after birth.

Into what two cla.s.ses may angiomata be roughly grouped?

The flat (or non-elevated) and the prominent (or elevated).

Describe the flat, or non-elevated, variety of angioma.

The flat, or non-elevated, angioma (_naevus flammeus_, _naevus simplex_, _angioma simplex_, _capillary naevus_) may be pin-head- to bean-sized; or it may involve an area of several inches in diameter, and, exceptionally, a whole region. It is of a bright- or dark-red color, and is met with most frequently about the face. In some instances it extends after birth, reaches a certain size and then remains stationary; occasionally, when involving a small area, it undergoes involution and disappears.

The so-called _port-wine mark_ is included in this group.

Describe the prominent, or elevated, variety of angioma.

The prominent variety (_venous n[oe]vus_, _angioma cavernosum_, _n[oe]vus tuberosus_) is variously-sized, often considerably elevated, clearly-defined, compressible, smooth or lobulated, and of a dark, purple color; it may, also, be erectile and pulsating. The growth is usually a single formation, and is met with upon all parts of the body.

What is the pathology of angioma?

It is a new growth, consisting of a variable hypertrophy of the cutaneous and subcutaneous arterial and venous bloodvessels, with or without an increase of the connective tissue.

Give the treatment of angioma.

In some instances, especially in infants, painting the parts repeatedly with collodion or liquor plumbi subacetatis will act favorably. For well-established, small, capillary naevi electrolysis or puncturing with a red-hot needle or with a needle charged with nitric acid may be employed; for "port-wine mark" frequent and closely contiguous electrolytic punctures are occasionally followed by a slight diminution in color. For the _prominent growths_, vaccination, the ligature, puncturing with the galvano-cautery, and excision are variously resorted to.

In recent years applications of liquid air and carbon dioxide have proved of service in some cases.

Telangiectasis.

Describe telangiectasis.

Telangiectasis consists of a new growth or enlargement of the cutaneous capillaries, usually appearing during middle adult life, and seated, for the most part, about the face.

To what extent may telangiectasis develop?

It may be limited to a red dot or point, with several small radiating capillaries (_naevus araneus_, _spider naevus_), or a whole region, usually the face, may show numerous scattered or closely-set capillary enlargements or new formations (_rosacea_). The latter is frequently a.s.sociated with acne (_acne rosacea_).

The etiology is obscure.

What is the treatment of telangiectasis?

Destruction of the vessels by electrolysis or by the knife. (See treatment of acne rosacea.)

Lymphangioma.

(_Synonym:_ Lymphangiectodes.)

Describe lymphangioma.

Lymphangioma is a rare disease, consisting of localized dilatations of the lymphatic vessels, appearing as discrete or aggregated pin-head or pea-sized, compressible, hollow, tubercle-like elevations, of a pinkish or faint lilac color, and occurring for the most part about the trunk.

It is of slow but usually progressive development, and is unaccompanied by subjective symptoms.

A rare condition, Kaposi described as lymphangioma tuberosum multiplex, characterized by more or less solid, somewhat cystic, pearly to pinkish red, sometimes crowded lesions, is now known to be "benign cystic epithelioma"; its most common site is the face. While called "benign,"

ulcerative action may eventually ensue.

Treatment, when demanded, consists of operative measures.