Definition. An acute, contagious, inflammatory disease of the newly born.
Symptoms. This comparatively rare condition has been best described by Ritter of Prague, who observed nearly three hundred cases in the Founding Asylum of that city. It usually begins between the first and third week of life as a diffused redness on the face or somewhere else on the body, or occasionally it is universal at the onset. In any instance, it spreads in a few days all over the surface, reaching the extremities last. Desquamation occurs at the first point of origin in large, branny scales. These are easily removed as they loosen at the edges, and underneath reveal a new epidermis. Sometimes a dry and scaly condition of the skin follows the normal changes in the epidermis after birth and preceded by a fluid exudation in the form of small vesicle or large, flaccid bullae. After desquamation, regneration of the epidemis occurs rapidly. There is little or no systemic fever or other symptoms unless complications arise, although mild may be affected, and boils, other pustular inflammations and gangrene may follow the disease. The duration is from one to two weeks.
Etiology and Pathology. The causes are not known; although the parasitic theory of its origin seems reasonable, it has not been proven. The pathology is not clear. Some believe with Kaposi that it is a perversion or excessive physiological exfoliation of the new born with secondary hyperemia. Others regard it as a pure dermatitis.
Diagnosis should be easy if the case is typical. Pemphigus foliaceus might resemble a few cases, but it always occurs in adult life and runs a chronic course.
Prognosis and Treatment. The former is grave, as is shown by a mortality of about fifty per cent. Treatment is directed toward frequent nourishment, protection of the surface with a nutrient fat like lanolin or sweet oil, and the internal administration of the indicated remedy, such as Arsenic and its salts.