. A practical treatise on diseases of the skin, for the use of students and practitioners. are due toaccidental rather than to essentialcauses. The eruption, which at theoutset may appear as late as the thirdyear, commonly displays itself first onthe neck and shoulders and then rapidlyspreads to the head and the extremities,eventually invading the entire body-surface—in well-marked cases even in-cluding the mucous membranes. Thelesions are at first of the usual urti-carial type, each with delicate zone, butsoon lose their distinct contour andelevation, and become flatter and pig-mented, the co
. A practical treatise on diseases of the skin, for the use of students and practitioners. are due toaccidental rather than to essentialcauses. The eruption, which at theoutset may appear as late as the thirdyear, commonly displays itself first onthe neck and shoulders and then rapidlyspreads to the head and the extremities,eventually invading the entire body-surface—in well-marked cases even in-cluding the mucous membranes. Thelesions are at first of the usual urti-carial type, each with delicate zone, butsoon lose their distinct contour andelevation, and become flatter and pig-mented, the color in pronounced casesbeing a distinct yellow, deepening to a decided coffee-and-milk isolated tubercles once acquire the deeper tint they may persistfor years; may return in crops ; may even at times be commingledwith bullae which desiccate in crusts; may form plaques of infiltra-tion ; may be covered at times with an erythematous blush due tohyperemia of parts long affected; and, when itching is intense, mayexhibit the general signs of the scratched skin. In some of the. Urticaria pigmentosa. (From aphotograph.) 172 DISEASES OF THE SKIN. reported cases, after involution, whitish instead of pigmented spots wereleft in a smooth or a wrinkled and scar-like skin. Etiology. The cause is unknown. The sexes are nearly equallyrepresented among patients. Pathology. Sections of tubercles have been made by numerous ob-servers, including Unna, Raymond, Pick, and Thin. It is clear thatsome effusion occurs in the corium with cell-infiltration and smallhemorrhages. The disorder is unquestionably an angio-neurosis dueto special changes of the vaso-motor centres. According to Brocq, thepredominant elements of the infiltration are the mast-cells. Diagnosis. Urticaria pigmentosa is to be distinguished from theslight pigmentation left after well-marked urticaria of later years bythe beginning of the disease in infancy and by the persistent buff-colored tubercles. Xanthoma in all its
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Keywords: ., bookauthorhydejamesnevins184019, bookcentury1800, bookdecade1890
