Page:Archives of dermatology, vol 6.djvu/262

250 visit a younger brother, aged 14, presented the same eruption on the left cheek.

The disease may last yet longer upon the hairy face and yet not give rise to inflammatory action, as in the next case.

Mr. H., aged 24 years, came for the treatment of an eruption of the face, with the following history: Nearly seven months previously a little spot like a mosquito-bite had appeared on the left cheek, which in three or four days enlarged to a small circle. It remained confined to the cheek for two or three months, and gradually spread to the neck and then to the other side of the face, always having the same appearance, namely, that of rings or circles. When first seen all the bearded face and also some non-bearded portions were the seat of a scaly eruption which exhibited some papules, but mainly circles, or rather parts of circles, of reddened, scaly surface, enclosing less red but scaly skin.

More commonly, however, the presence of the parasite in the beard excites inflammation which results in pustules and a peculiar boggy condition, in masses or lumps, which gave rise to the name formerly given to this affection, namely sycosis, from a supposed likeness of these masses to a fig (Greek 🇬🇷, a fig).

Mr. W., aged 23, came to me December 11, 1878, with the sides of both cheeks covered with masses of soggy lumps of inflammatory tissue, some of them having moderate scaling on the surface, others with pus exuding from open follicles, from which the hairs had fallen, while from many portions broken hairs could be easily extracted. Around and beyond the inflamed masses could be seen a slightly reddened surface, moderately scaly, presenting tolerably sharply defined outlines.

He gave a history that his father, who was an officer in the army, had ringworm of the face, and that he had been shaving with his utensils, when well-marked ringworm developed on his own face about September 1, nearly three months and a half previous to his visit. When he left him, September 15, he had already a number of well-defined circles upon his face. A microscopic examination of some of the broken hairs and scales from the less inflamed portions showed great abundance of the mycelium and spores of the trychophyton tonsurans.

He was directed to extract all the hairs possible from the diseased portions, and was given the following ointment: ℞.—Olei cadini, ʒi; Unguent, hydrarg. oxidi rub., ʒii; Unguent, aquæ rosæ, ʒvi.—M. Ten days later there was very great improvement; he was given some laxative pills, a bitter and alkaline tonic, and was directed to use sulphurous acid freely in the daytime, after washing off the ointment, which was to be kept very thoroughly applied during the night. An abscess had then formed under the right jaw, which was opened, and discharged a drachm or two of unhealthy, bloody pus.

One week later there was still greater improvement, the mass of inflammatory disease having largely disappeared; but there were