Definition- A congestive disorder of the skin, usually caused by some disturbance of the vasomotor nervous system and characterized by pink or red non-elevated patches of variable size and shape.
Symptoms. Redness of almost any hue, which always disappears under pressure, no signs of infiltration, induration or elevation, and mild subjective symptoms, such as burning, itching, stinging or biting, may be noted. The irritation may be widely distributed or localized, of almost any size, due to the coalescence of smaller lesion, but usually of an irregularly rounded shape.
Erythema neonatorum is a diffused, often universal redness of the skin, beginning soon after birth, and usually caused by friction from washing, rubbing, or the clothing. There is no desquamation and the whole condition disappears within a week. There may be a change from a red to a yellowish color of the skin, and occasionally a few hemorrhagic points.
Erythema traumaticum is the simplest irritation from pressure, friction, rubbing, etc., such as would develop from the pressure of a truss, pad, tight garter or eye-glasses.
Erythema caloricum is a redness from exposure to the extremes of temperature, hear or cold. When this erythema results from the influence of the sun’s rays, it is called erythema solare. When due to exposure to artificial heat, such as would occur on the anterior surfaces of the legs of cooks, stokers, and kitchen employees, it is called erythema abligne, and often presents annular and gyrate patches.
Erythema venenatum is applied to the local redness caused by the superficial action of such drugs as capsicum, cantharides, mustard, belladonna, chloroform, etc. Full discussion of this subject will be found under dermatitis venenata.
There are a number of conditions, specific designations of which are confusing, but which must be mentioned for the sake of completeness; thus erythema paratrimma denotes redness from pressure over a bony prominence, which may presage a bed sore; erythema leve represents the shining, tense redness seen on edematous extremities; erythema fugax is a transitory patchy urticarial redness; erythema medicamentosum will be considered under dermatitis medicamentosa; erythema gangrenosum will be found under dermatitis gangrenosa; erythema pernio (chilblain) will be described under dermatitis calorica, and erythema vacciniforme is included among the vaccination eruptions.
Erythema intertrigo (chafing) is the commonest form of traumatic erythema, occurring principally on those surfaces which are in apposition, such as the axillary and genito-urinary regions, beneath the breasts, overheated, overdressed and overfed individuals, and among young children because they cannot explain and thus prevent moist clothing and irritating discharges from causing this condition. Often a true dermatitis or even an eczema may develop from these simple beginnings. The subjective symptoms are those of burning, itching and soreness.
Etiology. When not traceable to definite local causes, many of which have been mentioned, simple erythema is a toxemia, frequently intestinal in origin. Age is a predisposing influence because children are susceptible to gastrointestinal disorders.
Prognosis and Treatment. The former is nearly always favorable, but if the attacks are due to personal idiosyncrasy, recurrences may be expected. Treatment is expectant or symptomatic in character, and because of the prevalence of auto- intoxication as a causal factor, should embrace careful examination of the urine to discover conditions of hyperacidity, indicanuria and oxaluria. High saline enemas, a culture of the bacillus Balgaricus and laxatives may be essential. Commonly, any local irritant should be stopped if suspicious of its irritation qualities. Cooling and mildly antiseptic lotions of boric acid, weak carbolic acid, weak alcoholic, or 2 per cent. lysol may precede the use of dusting powder. The following may be cited a useful formulae:
R Pulv. ac. borici, 3j; 4
Pulv. zinci, oxidi, 3ij; 8 M.
Pulv.talci, 3v; 20
R Phenolis, mxxx; 2
Acidi borici, 3j; 4
Glycerini, 3ij; 8 M.
Zinci oxidi, 3j; 4
Aquae q.s.ad 3vj; 180
Glycerini, aa 3j; 4
Aquae hamamelidis 3j; 30 M.
If an active dermatitis or eczema supervenes, the treatment is directed toward these conditions. Among remedies suggested are Aconite, Agaricus, Arnica, Belladonna, Benz. acid, Boxas, Cad., Cantharis, Caps., Carbo. ani., Crot., Graphites, Hepar., Hypericum, Lycop., Mercurius viv., Nat. phos., Nit. acid. Nux vomica, Rhus tox., and Sulphur.