File:An American text-book of genito-urinary diseases, syphilis and diseases of the skin (1898) (14782387162).jpg

Identifier: americantextbook00bang (find matches)
Title: An American text-book of genito-urinary diseases, syphilis and diseases of the skin
Year: 1898 (1890s)
Authors: Bangs, Lemuel Bolton, 1842-1914 Hardaway, W. A. (William Augustus), 1850-1923
Subjects: Urogenital System Urination Disorders Syphilis Skin Diseases
Publisher: Philadelphia, W. B. Saunders
Contributing Library: Columbia University Libraries
Digitizing Sponsor: Open Knowledge Commons

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system the disease can be regarded as a neurosis. It is not an affec-tion of the sweat-glands, as originally maintained by Tilbury Fox, who gaveit the name of dysidrosis. Anatomy.—In the earliest stage the vessels contain clear serum anda few, if any, leukocytes; afterward pus-corpuscles appear, and continue to 826 INFLAMMATIONS. increase in number until the contents are yellowish in color. The fluid isnever acid and contains a large amount of albumin and some fibrin. Itcomes from the papillary blood-vessels, collecting between the rete-cells toform the lesions. These are situated usually in the upper part of the rete.The liquid causes degeneration of some cells, and, collecting, presses the sur-rounding cells in different directions. The larger the vesicle, the more therete-cells are flattened and drawn out, until some of them look like fibers.The stratum lucidum is pushed upward and occasionally ruptured, as inFig. 236. The corneous layer often shows many small loculi from escaped
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Fig. 236.—Vesicle in pompholyx: a, corneous layer; 6, stratum lucidum: c, rete; d, eorium; e, vesicle.The sweat-glands are normal and show no connection with the lesions. sweat. The inflammatory changes in the eorium are slight, consisting ofperivascular leukocyte-collection and some edema from serum-transudation. Diagnosis.—The only difficulty is to diagnose from acute neuroticeczema of the hands. Some authors regard pompholyx as an eczema, but inwell-marked cases the symptoms are characteristic and stamp the affection asnot a catarrhal dermatitis. From weeping eczema the diagnosis is easy, as inpompholyx the lesions are not acuminate, and there is no exudation on thefree surface and but little inflammation present. In neurotic eczema the erup-tion is often symmetrical and the lesions grouped, as in pompholyx, but theinflammatory swelling is greater, the lesions soon become more acuminated,they are liable to exist upon the back and sides of the fingers more thanupon the palm, and

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