ERYTHEMA PUDORIS. — This form bears considerable analogy to the above, but it is the expression of menstrual dis turbances, pregnancy, climatic influ ences, and general disorders. The dif ference between this and the foregoing variety lies in the cause. This latter affection is the result of some psychical influence, and usually progresses as the patient ages. Chronic blushers belong to this category.
Erythema Venenatum.—Certain min eral and vegetable substances also pro duce an erythema, but if the contact is prolonged actual inflammation takes place, and vesicles, pustules, or other symptoms may be observed. This form of erythema occupies the point of con tact, and is manifested by a distinct, pinkish-red, irregular patch of small or large size, according to the amount of surface acted upon by the irritant. Mus tard, cantharides, sulphur, strong soaps, ivy and other plants, acids, and many other drugs may be mentioned as some of the causes. This form of erythema usually persists for some time after the removal of the causative influence, and in cases in which the skin is delicate the most energetic treatment will be de manded.
Erythema Caloricum.—Both heat and cold may give rise to erythema. That in duced by heat is diffuse, and, although its disappearance follows immediately upon the withdrawal of the causal factor, it may persist for some time in fair skins, to be, in turn, followed by some degree of desquamation. Exposure to the ac tinic rays of the sun is the usual and greatest exciting cause, although it is ob served in many persons who are obliged to work around stoves or machinery.
Patient who suffered from a relapsing solar erythema on the backs of the hands. For six consecutive years this disease appeared at a time of the year during which it had first made its ap pearance; it involved the backs of the hands; the face, shaded by the hat, had escaped. The patient was an alcoholic; the liver was enlarged. Dreyfus (Pro vince Med., June 19, '9S).
Cooks, stokers, and men or women who toast their shins before the open grate present gyrate patterns and annu lar patches of redness (Erythema ab igne, Crocker). This condition generally dis
appears without leaving any trace, but there are cases in which the causative in fluence is often repeated; some degree of pigmentation is induced and may persist for long periods, if it is ever at all re moved. Hammer refers to certain cases in which the action of the sun's rays dis appears immediately upon entrance in doors, and speaks of these cases as not being influenced by the heat of a fire, but as being observed in winter as well as in slimmer. Cold exerts a similar influence upon certain subjects and is shown by a livid, bluish, or cyanotic appearance at the point of contact. Exposed for long periods pigmentation may be observed, or the condition may terminate in in flammation or ulceration.
Erythema Traumaticum.—Violence of slight degree causes a diffuse redness at the point of contact, which may vary from a slight tinge of yellowish red to that of a dark red. Even under slight traumatism, if contact is allowed to con tinue, the condition will induce inflam mation with all its consequent phenom ena of vesicles, pustules, or bullous lesions. Complications may arise in the form of a true dermatitis, eczema, or other form of irritation or ulceration, and permanent pigmentation follow.
The exciting agencies are numerous, and the degree of injury depends upon the actual cause. Ill-fitting wearing ap parel or even bed-dressings, tight garters, shoes, trusses, and diapers are some of the factors most commonly met with, while fzeces and salivary and leucorrhceal discharges may represent another class among causal conditions. Repeated at tacks leave the point of affection prone to other affections; the most important of these is bed-sore, which occurs as the re sult of being too long in one position and thus inducing pressure upon one portion of the body, or lying upon rough and unclean bed linen. Certain occupa tions tend to the production of local ery thema, as, for instance, in the case of persons who are obliged to remain seated for long periods, as shoemakers, or those who stand indefinitely, as clerks.