ICHTHYOSIS Iehtliyosis is an affection which occurs in earliest infaney, usually in the first or second year, and which is peculiar for the formation of thick, adhesive scales and horny masses, also for its chronic course. Pathological Picture.—The affection, which generally appears diffuse, rarely localised, forms more or less gray, thick stratifications upon the skin, which is dry, brittle, and divided into irregular squares which are separated by furrows. There is no itching, sensitiveness is maintained, secretion of fat and sweat diminished. The affection is very often hereditary and attacks preferably the male members of a family. Its favorite sites are the extensor surfaces of the extremities, the trunk, less often the face. The lower extremities are most frequently involved, the articular flexures are usually free; if the face is involved, it assumes a peculiar rigid expression: there is ectropium and fissures around the angles of the mouth. Aeeording to its degree of severity ichthyosis is divided into three forms: (1) ichthyosis simplex or nitida (polygonal scales, gray skin like that of a fish, described by Besnier xeroderma or ichthyosis furfuracea, and as existing in the first few years of life); (2) ichthyosis serpentina or sauriasis, Wilson (crocodile skin, euirass-like covering, rigid verrucous eminences); (3) iehthyosis hystrix (with special participation of papillte, verrucous aculcate excres cences (" porcupine" beings). The course of ichthyosis is progressive up to puberty, then as a rule it stops. Eczema may occur as a complication.
Pathological corneal layer is enormously devel oped, tbe granular layer is absent, the aculeate layer is only narrowly developed. There is an immediate transition from the cells of the
rete to those of the corneal layer. The papilla, are strongly developed, especially in ichthyosis hystrix. Kromeyer holds the peculiar sclerotic connective tissue responsible for the causation of ichthyosis.
cause of ichthyosis is unknown to us, although there is no doubt that heredity plays an important role. Reyer for instance has described ichthyosis in six generations; it may pass over several generations and reappear later. It is a remarkable fact that the disease is endemic in certain region6 (the Moluceas. Paraguay and the Miriditcs) especially with the male part of the populace.
The prognosis is unfavorable as far as a cure is concerned, the disease being considered incurable, although it may be relieved by treatment.
object of the treatment is to remove the scales by all methods which have a keratolytic effect. There are in the first place baths: sulphur (Vlemingkx' solution 30 to 50 Gin.), potassium (50 to 100 Gm.), borax (30 to 50 Gm.), or simple soap or steam baths; also sweat cures should be resorted to for the softening of the skin. At the same time washing with sulphur soap, salicylic soap, resorcin soap, green soap are advisable, also inunction of the body with salicy lic vaselin, salicylic sulphur ointment or Hebra's ointment (caution: simultaneous sulphur preparations on account of the formation of sulplauret of lead). Rheumasan ointments also have a very strong keratolytie effect. For localized ichthyosis resorcin plastermull and salicylic soap plaster are likewise recommendable.