Page:Skin Diseases of Children.djvu/127

Rh cases to originate in the same locality. Children suffering from molluscum are especially prone to have warts upon the hands.

The diagnosis of molluscum is usually made with ease by any one at all familiar with the appearance of the tumors. Large milia upon the face might be mistaken for them; but these tumors are rounded, of much firmer consistence, not likely to occur in groups, and always lack the characteristic flattened surface and central umbilication.

The treatment of molluscum is simple and effective. Many of the tumors, after a duration of a few weeks or months, undergo a process of destructive inflammation, and a spontaneous cure results. This is especially apt to be the case when two are close together and coalesce as they increase in size. If a tumor is vigorously compressed and the contents evacuated it will usually disappear. Incision and cauterization, or abscission by means of a sharp knife, have been recommended, but the simplest method of removing the tumors is to scrape them quickly with a curette and to lightly touch the bleeding surface with nitrate of silver. The main object in treating these tumors is to destroy them completely and to excite as little inflammation as possible in so doing. When even a large molluscum is removed by means of the curette no scar or trace of the growth is usually left, since the tumor is an outgrowth of the epidermis and does not involve the true skin. But when an inflamed molluscum is scratched or irritated to the extent of inducing a purulent secretion, a slight pit may be expected to result.

Keratosis follicularis is an affection not infrequently seen in childhood, especially among children who are poorly cared for. It is the result of an abnormally dry condition of the skin and the accumulation of epidermic scales in the hair follicles. This produces an eruption of small, conical papules, which are commonly found upon the outer aspect of the extremities. These are usually of the color of the skin. Sometimes they are discolored by dirt, and in some cases they become inflamed and present a dull-red hue. The fine hairs growing upon the affected skin are often broken off or coiled up in the follicles. When the disease is severe and of several years' duration the .skin has an ichthyotic appearance and to the touch feels like a nutmeg grater. The disease is described in some text books under the name of lichen pilaris or keratosis pilaris, but the follicle is primarily involved and not the hair. Recently the term keratosis follicularis has been applied by some writers to