QUEEN VICTORIA
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Ichthyosis
Synonyms:
Fish skin.
Definition:
Ichthyosis is a hereditary or congenital disease of the skin of hypertrophied nature, characterized by scaling off of the epidermis, dryness, roughness, and sometimes warty growths.
Etiology:
The disease, being congenital, is of course directly or indirectly inherited, often, however, passing over several generations. It has frequently been noticed to follow up one side of the family, that is, only the boys were affected, and vice versa the girls. This, we know, is peculiar to alopecian syphilis, as well as other diseases of syphilis, also of psoriasis.
Pathology:
Like most forms of skin hypertrophy there is seen a true hypertrophy of the epidermis and papillary layer of the corium.
Symptoms:
There are three clinical types or forms, xerosis, ichthyosis simplex, and ichthyosis hystrix. The xerosis, or xeroderma, is the common form, although the symptoms are less marked. It is milder and does not change much throughout life. The skin has an unwashed, dry, roughened appearance, lacking that oily appearance it usually has. Closely adherent, fine, whitish, or grayish-white scales form upon the surface of covered parts, more especially the anterior or extensor surfaces of the body. They are decidedly prominent, resembling keratosis pilaris. The disease is very mild during the warm summer months, almost disappearing, but to be renewed again in winter with all its former severity. It is generally more marked in middle life. The simplex form comes earlier in life, soon after birth. The scales are larger and the surface of the skin is marked by polyhedral inter spaces similar to a tiled floor. The color of the scales is from a dull white to a dark red color; like the former disease, it is more marked in cold climates, especially in winter. There is almost no perspiration, therefore the body presents that dry, harsh, roughened, scaly appearance similar to the scales of a fish. The hair is also dry and lustreless. If the scales are forcibly removed, or even between the scales, the form of the blood-vessels can be seen. Itching, soreness, tenderness, and many very annoying or abnormal sensations are present during the cold season of the year. Yet these patients do not complain much from cold, nor do they suffer much from heat.
Diagnosis:
The early appearance of the disease, soon after birth, the rough, dry, scaly, polygonal plates, dirty gray in color, together with that general appearance of the skin of a fish, renders the diagnosis easy.
Prognosis:
Not very favorable, years of treatment being required to cure these subjects.
Treatment:
Change of climate does much for these patients, high, dry mountain air, or a prolonged sea voyage greatly relieves them; but it is prone to return. sooner or later, until the constitutional dyscrasia is rectified. Warm bran water baths are soothing. The free use of olive oil relieves the dryness to some extent, modifies the irritation find softens the skin in a mechanical way. as there are no natural secretionsREMEDIES The remedies from which we have seen the best results in this disease are: Ars, Ars. iod., Syph., Tub., Psor., Sulph., Graph., Aur., Cal. c., Mer. sol., Nuph. lutea, Pet., Phos., Sarracen. Tell., Teucr., Sep., Hydrocotyle, Iod., Lyc., Sil. Arsenicum alb., Ars. iod., Syph., Psor., Tub., Petrol., Graph, have done more in my hands in the curing of this disease than all other remedies.
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