Essentials of Diseases of the Skin Part 5

Mild antiseptic and astringent lotions or dusting powders should also be advised.

_Red chromidrosis_ or _Pseudochromidrosis_ is a condition in which the coloring of the sweat occurs after its excretion and is due to the presence of chromatogenous bacteria which are found attached to the hairs of the part in agglutinated ma.s.ses. The axilla is the favorite site. Treatment consists of frequent soap-and-water washings, and the application of boric acid, resorcin, and corrosive sublimate lotions.

Uridrosis.

Describe uridrosis.

Uridrosis is a rare condition in which the sweat secretion contains the elements of the urine, especially urea. In marked cases the salt may be noticeable upon the skin as a colorless or whitish crystalline deposit.

In most instances it has been preceded or accompanied by partial or complete suppression of the renal functions.

Phosphoridrosis.

Describe phosphoridrosis.

Phosphoridrosis is a rare condition, in which the sweat is phosph.o.r.escent. It has been observed in the later stages of phthisis, in miliaria, and in those who have eaten of putrid fish.

Seborrh[oe]a (Eczema Seborrhoic.u.m).

_Synonyms:_ (Steatorrh[oe]a; Acne sebacea; Ichthyosis sebacea; Dandruff.)

What is seborrh[oe]a?

Seborrh[oe]a is a disease of the sebaceous glands, characterized by an excessive and abnormal secretion of sebaceous matter, appearing on the skin as an oily coating, crusts, or scales.

In many cases the sweat-glands are likewise implicated, and the process may also be distinctly, although usually mildly, inflammatory.

At what age is seborrh[oe]a usually observed?

Between fifteen and forty. It may, however, occur at any age.

Name the parts most commonly affected.

The scalp, face, and (less frequently) the sternal and interscapular regions of the trunk. It is sometimes seen on other parts.

What varieties of seborrh[oe]a are encountered?

Seborrh[oe]a oleosa and seborrh[oe]a sicca; not infrequently the disease is of a mixed type.

What are the symptoms of seborrh[oe]a oleosa?

The sole symptom is an unnatural oiliness, variable as to degree. Its most common sites are the regions of the scalp, nose, and forehead. In many instances mild rosacea coexists with oily seborrh[oe]a of the nose.

Give the symptoms of seborrh[oe]a sicca.

A variable degree of greasy scalines, which may be seated upon a pale, hyperaemic or mildly inflammatory surface.

The parts affected are covered scantily or more or less abundantly with somewhat greasy, grayish, or brownish-gray scales. If upon the scalp (_dandruff_, _pityriasis capitis_), small particles of scales are found scattered through the hair, and when the latter is brushed or combed, fall over the shoulders. If upon the face, in addition to the scaliness, the sebaceous ducts are usually seen to be enlarged and filled with sebaceous matter.

Describe the symptoms of the ordinary or mixed type.

It is common upon the scalp. The skin is covered with irregularly diffused, greasy, grayish or brownish scales and crusts, in some cases moderate in quant.i.ty, in others so great that large irregular ma.s.ses are formed, pasting the hair to the scalp. If removed, the scales and crusts rapidly re-form. The skin beneath is found slate-colored, hyperaemic or mildly inflammatory, and exceptionally it has in places an eczematous aspect (_eczema seborrhoic.u.m_). Extraneous matter, such as dust and dirt, collects upon the parts, and the whole ma.s.s may become more or less offensive. There is a strong tendency to falling-out of the hair.

Itching may or may not be present.

[Ill.u.s.tration: Seborrh[oe]a (Eczema Seborrhoic.u.m).]

Describe the symptoms of seborrh[oe]a of the trunk and other parts.

[Ill.u.s.tration: Fig. 7.

A normal sebaceous gland in connection with a lanugo hair.

(_After Neumann._) _a_, Capsule; _b_, fatty secretion; _c_, _h_, secreting cells; _d_, root of lanugo hair; _e_, hair-sac; _f_, hair-shaft; _g_, acini of sebaceous gland.]

Seborrh[oe]a corporis differs in a measure, in its symptoms, from seborrh[oe]a of the scalp and is usually ill.u.s.trative of the variety known as eczema seborrhoic.u.m; it occurs as one or several irregular or circinate, slightly hyperaemic or moderately inflammatory patches, covered with dirty or grayish-looking greasy scales or crusts, usually moderate in quant.i.ty, and upon removal are found to have projections into the sebaceous ducts. It is commonly seen upon the sternal and interscapular regions. It rarely exists independently in these regions, being usually a.s.sociated with and following the disease on the scalp. It may also invade the axillae, genitocrural, and other regions.

What is the usual course of seborrh[oe]a?

Essentially chronic, the disease varying in intensity from time to time.

In occasional instances it disappears spontaneously.

Give the cause or causes of seborrh[oe]a.

General debility, anaemia, chlorosis, dyspepsia, and similar conditions are to be variously looked upon as predisposing.

In some instances, however, the disease seems to be purely local in character, and to be entirely independent of any const.i.tutional or predisposing condition. The view recently advanced that the disease is of parasitic nature and contagious has been steadily gaining ground.

What is the pathology of seborrh[oe]a?

Seborrh[oe]a is a disease of the sebaceous glands, and probably often involving the sweat-glands also; its products, as found upon the skin, consisting of the sebaceous secretion, epithelial cells from the glands and ducts, and more or less extraneous matter. Not infrequently evidences of superficial inflammatory action are also to be found, and it is especially for this type that the name eczema seborrhoic.u.m is most appropriate. In long-continued and neglected cases slight atrophy of the gland-structures may occur.

With what diseases are you likely to confound seborrh[oe]a?