LIST OF CONTRIBUTORS VOL. XVII. H. MELVIN ALLEN, M.D., of Philadelphia, Pa. A. CLAUS, M.D., of Ghent, Belgium. WILLIAM S. GOTTHEIL, M.D., of New York. WILLIAM B HOPKINS, M.D., of Philadelphia, Pa. . M. KOCH, M.D., of Philadelphia, Pa. J. MOUNT BLEYER, M.D., F.R.A.M.S., Naples, of New York. A. M. PHELPS, M.D., of New York. WILLIAM S. PRICE, ESQ, of Philadelphia, Pa. ALBERT E. ROUSSEL, M.D., of Philadelphia, Pa. A. ROUTIER, M.D., of Paris, France, EMIL SCHNEE, M.D., of Carlsbad and Nice. H. H. SHERK, M.D., of Cramer Hill, N. J. JOHN V. SHOEMAKER, A.M., M.D., LL.D., of Philadelphia, Pa. 3734 ACNE, PSORIASIS, AND ALOPECIA G CIRCUMSCRIPTA.* BY JOHN V. SHOEMAKER, A.M., M.D. ENTLEMEN: E. M., male, 22 years of age, a tailor, single, exhibits a coexistence of two diseases of the skin. Spots of acne are scattered over the face, principally upon the nose and forehead. The lesions are both papular and pustular, though the former prevail. They have been present at intervals for several years. At times his face will be free, or nearly so, and again fresh crops will appear. This is a very common history of acne. The psoriasis is of recent occurrence. About three months ago an eruption appeared upon both legs. It came out at nearly the same time on each, the right limb being affected rather earlier than the left. When first developing it was attended with some itching and burning sensations. The lesions have always been dry. They soon became covered with grayish scales, and when the man first came under observation his limbs presented a typical picture of psoriasis. It first attacked the outer. side of the legs, but has spread to the inner surfaces. The patient states that he enjoys good general health, and is strong. He cannot, however, be called very robust. His appetite is not very good; his bowels are regular. He is not dyspeptic, and has never had rheumatism or syphilis. He does not know of any rheumatism or psoriasis as occur * Delivered at the Medico-Chirurgical Hospital of Philadelphia. No. I ring in his family. Small spots of psoriasis exist upon his hands. As Here, as in other patients whom I have shown you, we obtain the same history of the psoriasis developing first upon the leg, in front of or just below the knee. Moderate itching attended the beginning of the disease, but soon subsided. In this respect, also, the history agrees with that of other cases. regards its evolution, it is distinguished by being rapid and diffuse. In a few weeks' time numerous patches appeared and coalesced, so as to form an almost uniform surface of diseased action. The scales have, for the most part, been detached, leaving the front of each leg almost covered by a dry, slightlyraised, somewhat-rough, dark-red and shining eruption. This man was directed to sponge his face every night with hot water and to wash every morning with naphthol soap. In respect to the psoriasis, he was placed upon the wine of antimony in doses of 5, increasing to 10, minims three times a day. As a local application to the psoriatic patches, he was ordered an ointment composed of 1 drachm of salicylic acid and an ounce of the ointment of the nitrate of mercury. The color of the lesions is less bright than when the patient first came under observation, and there is but a slight tendency to the reproduction of fresh scales. Alopecia and Psoriasis.-H. M., male, aged 37 years; an iron-worker. About ten years ago this man's hair began to fall in spots or patches. The hair was originally thick. The baldness began on the vertex. The denuded spots were at first roundish, but as they grew larger adjacent spots coalesced. |