Part 25

Itching, or a feeling of burning, slight or intense, is usually present.

#What is the course of the eruption?#

The vesicles show no disposition to rupture, but dry up in a few days or a week, disappearing by absorption and with slight subsequent desquamation; the papular lesions gradually fade away, and the affection, if the exciting cause has ceased to act, terminates.

#What is the cause of miliaria?#

Excessive heat. Debilitated individuals, especially children, are more prone to an attack. Being too warmly clad is often causative.

#What is the nature of the disease?#

The affection is considered to be due to sweat-obstruction, with mild inflammatory symptoms as a cause or consequence, congestion and exudation taking place about the ducts, giving rise to papules or vesicles, according to the intensity of the process.

#How would you distinguish miliaria from papular and vesicular eczema, and from sudamen?#

The papules of eczema are larger, more elevated, firmer, slower in their evolution, of longer duration, and are markedly itchy.

The vesicles of eczema are usually larger, tend to become confluent, and also to rupture and become crusted; there is marked itchiness, and the inflammatory action is usually severe and persistent.

In sudamen there is absence of inflammatory symptoms.

#What is the prognosis of miliaria?#

The affection, under favorable circumstances, disappears in a few days or weeks. If the cause persists, as for instance, in infants or young children too warmly clad, it may result in eczema.

#What is the treatment of miliaria?#

Removal of the cause, and in debilitated subjects the administration of tonics; together with the application of cooling and astringent lotions, as the following:--

Aeidi carbolici, ..................... ss-j Acidi borici, ........................ iv Glycerinæ, ........................... fj Alcoholis, ........................... fij Aquæ, ................................ xiv. M.

This is sometimes more efficient if zinc oxide, six to eight drachms, is added.

Lotions of alcohol and water or vinegar and water, and also the various lotions used in acute eczema, are often employed with relief.

Dusting-powders of starch, boric acid, lycopodium, talc, and zinc oxide are also valuable; the following combination is satisfactory:--

Pulv. acidi borici, Pulv. talci veneti, Pulv. zinci oxidi, Pulv. amyli, .............[=a][=a].....ij. M.

Probably the best plan is to use a lotion and a dusting-powder conjointly; dabbing on the wash freely, allowing it to dry, and then dusting over with the powder.

#Pompholyx.# (Synonyms: Dysidrosis; Cheiro-pompholyx.)

#What is pompholyx?#

Pompholyx is a rare disease of the skin of a vesicular and bullous character, and limited to the hands and feet.

#Describe the symptoms of pompholyx.#

In most instances the hands only are affected. It begins usually with a feeling of burning, tingling or tenderness of the parts, followed rapidly by the appearance of deeply-seated vesicles, especially between the fingers and on the palmar aspect. These beginning lesions look not unlike sago grains imbedded in the skin. In some instances the disease does not extend beyond this stage, the vesicles disappearing after a few days or weeks by absorption, and usually without desquamation. Ordinarily, however, the lesions increase in size, new ones arise, become confluent, and blebs result, the skin in places appearing as if undermined with serous exudation. The parts are commonly inflamed to a slight or marked degree. The skin comes off in flakes, new lesions may appear for several days or two or three weeks, and the process then declines, recovery gradually taking place.

There are no constitutional symptoms, although it is usually noticed that the general health is below par.

#What is the character of the subjective symptoms in pompholyx?#