Skin Diseases (2)

BARBER'S ITCH.

CANDIDIASIS (MONILIASIS).

Candidiasis of the skin, caused by the same organism that causes thrush in the mouths of babies, may affect the mucous membranes of the digestive tract or the vagina in debilitated peo­ple or those who have been taking an­tibiotics by mouth for a long time. It most commonly attacks obese people, people who sweat freely, or people who have diabetes mellitus.

The skin areas most commonly in­volved are the regions around the anus or vagina, corners of the mouth, finger­nail folds, and/or the body folds. The affected areas are red, raw, and beefy in appearance, but may have whitish, curd-like deposits on their surfaces. There may be mild burning sensations present, but itching is much more likely to be troublesome. Warmth and mois­ture make the condition worse.

What to Do

1. If the afflicted person has been taking antibiotic by mouth, this medication should be stopped at once.

2. Have a physician make the necessary examinations to detect the possible presence of diabetes melli­tus, and, if found, to start vigorous treatment for it.

3. If the afflicted person is obese, continue a weight-reducing program until a normal weight is reached.

4. Keep the affected skin areas as cool and dry as possible.

5. Apply 1 percent gentian violet solution to the affected skin areas twice a week. Vioform 3 percent cream is also useful and has less ten­dency to stain the skin and clothing.

6. Griseofulvin is not of value in this condition, but a physician may be able to prescribe other and more effective remedies that cannot be purchased without a prescription.

RINGWORM OF THE BEARD (BAR­BER'S ITCH).

Ringworm of the beard is a conta­gious disease caused by a parasitic fun­gus, beginning with inflammation in and around the hair follicles of the beard. It is more persistent than either ringworm of the scalp or ringworm of the body, but fortunately it is not very common. It may be contracted in insanitary barbershops.

Small, superficial nodules appear at first. Later these become larger and more deep-seated because the parasites work down to the bottom of the folli­cles. Inflammation is general over the skin of the affected areas, but more marked over the nodules, which have a tendency to occur in groups. Usually a brittle hair projects from the center of each nodule. It is loose and can be pulled out easily.

The follicles may dis­charge thin pus. The disease causes considerable itching and discomfort, and it is sometimes mildly painful.

A staphylococcic infection of the bearded area may closely resemble ringworm of the beard, except that the hairs do not loosen. It requires differ­ent treatment. Partly because of this fact, self-diagnosis is not easy, and self-treatment may not succeed, so in any suspected case of barber's itch a der­matologist should be consulted.

What to Do

1. The person who suspects that he may have barber's itch should carefully guard others from infec­tion by not letting anybody else use his razor, toilet articles, washcloths, or towels; and each time after using such articles himself he should steri­lize them.

2. Secure the services of a physi­cian, if possible. If not, try the treat­ment recommended under Ring­worm of the Scalp.

RINGWORM OF THE BODY (TINEA CIRCINATA, TINEA COR­PORIS).

Ringworm of the body is a mildly contagious disease caused by a fun­gous infection affecting the skin of the face, neck, body, arms, and legs. It is characterized by reddened patches, round or irregular in shape, and usu­ally scaly. The patches are pea-size at first, but grow rapidly. They usually have a tendency to heal in the center, thus forming rings. The outer edges of the rings consist of tiny papules and a few small blisters.

These are slightly elevated, causing the centers to look depressed. The rings may become as much as two inches (5 cm.) broad. Sometimes they do not heal in the cen­ter, but continue as inflamed and more or less scaly patches. This disease causes no feeling of general illness and only a mild itching, but it is quite un­sightly. It is frequently contracted through contact with infected domestic animals, especially cats.

What to Do

1. Apply calamine lotion to the affected areas every three hours dur­ing the day to help control itching.

2. Every night for one week apply half-strength Whitfield's ointment or an undecylenic acid ointment such as Desenex. Avoid getting this oint­ment near the eyes. If the Whitfield's ointment is at all irritating, dilute it to quarter-strength or less with pet­rolatum, or use 10 percent undecylenic acid ointment instead. Do not overtreat.

3. Griseofulvin taken under a phy­sician's supervision is an effective remedy for ringworm of the body.


RINGWORM OF THE GROIN (CROTCH ITCH, JOCK ITCH).

Ringworm of the groin manifests it­self as brownish or reddish, somewhat scaly patches, with tiny blisters at the spreading edges, commonly affecting the inner surface of the upper thighs, the scrotum, the groin, the perineum, and the anal region.

This condition may be caused by different kinds of fungi, and by some is considered as only another variety of ringworm of the body. In many cases the same pa­tient has athlete's foot the probable source of fungous infection which now affects the skin of the groin. Heat, moisture, profuse perspiration, and chafing by the clothing can prepare the way for the infection to take hold. It is more common and more troublesome in the tropics than in cooler climates. Mild itching or smarting sensations are the only forms of discomfort caused by it.


What to Do

1. Keep the affected skin areas as clean and dry as possible. Wear cool, soft, loose-fitting clothing.

2. Just before bedtime take a tepid 1:5,000 potassium permanganate or starch sitz bath. Dry the skin thor­oughly and apply half-strength Whitfield's ointment or 10 percent undecylenic acid ointment thinly. If ointments tend to keep the skin moist, do not continue their use, but use a small .amount of dilute (not more than 1 percent) tincture of. io­dine, and let it dry on.

3. In the morning, dust on talcum powder containing 10 percent of cal­cium propionate. Use this powder freely during the day to decrease friction when walking.

4. Griseofulvin taken under a phy­sician's supervision is an effective remedy for ringworm of the groin.

RINGWORM OF THE NAILS.

This fungous infection causes the nails to become thickened, brittle, bro­ken, white, and often ridged. It seldom, if ever, causes any pain, itching, or other discomfort, and frequently only one nail is affected. It is an exceed­ingly persistent infection, however, and only the expert attention of a skin spe­cialist is likely to bring about a cure. It can be caused by one or more of the many kinds of fungi that cause ring­worm of other kinds. In extreme cases, the nails degenerate into irregular masses of hard, crumbly material, with little or no resemblance to normal nails. Surgical removal of the diseased nails may be necessary for a cure.


What to Do

1. Mechanical removal of as much of the affected nail as possible by chipping and scraping is an impor­tant part of any successful treatment. This can often be done most con­veniently by the patient after he has thoroughly soaked the hand or foot in warm water.

2. While not curative, the follow­ing applications have been recom­mended: (a) double strength Whit-field's ointment, (b) 5 to 7 percent tincture of iodine followed by regu­lar strength Whitfield's ointment, (c) a saturated solution of sodium thiosulfate in water.

3. Consult a skin specialist if pos­sible, as self-treatment cannot be expected to do any permanent good. Griseofulvin taken under a physi­cian's supervision for six to twelve months is probably the most effec­tive remedy yet found, but surgery may be needed.


RINGWORM OF THE SCALP (TINEA CAPITAS).

Ringworm of the scalp appears first as small, round, reddish, scaly spots with blisters. The spots enlarge rapidly, become grayish in color, show definite boundaries, and generally cause loss of hair. The infection seldom, if ever, at­tacks persons past puberty; and if it is present earlier, it tends to clear up by itself when puberty arrives.


When the affected spots are numer­ous, they may grow together, forming large, irregular patches. The hair in these spots becomes dry, lusterless, and brittle, breaking off and leaving short stumps which can easily be pulled from the scalp. Baldness may occur, but it is not likely to be permanent. There tends to be a constant mild itching of the scalp. The disease is usually cur­able within a few months.


Ringworm of the scalp may be caused by more than one variety of fungus. One form is caught by contact with pets, especially kittens or puppies, which may carry the causative orga­nisms without showing signs of active infection. It may also be acquired through contact with an infected per­son or contaminated article, in a bar­bershop, by wearing somebody's con­taminated hat, or by using somebody's contaminated comb or hairbrush.


What to Do

Griseofulvin taken for two weeks under a physician's supervision is usually curative.


TINEA VERSICOLOR.

Tinea versicolor manifests itself as small, rounded, velvety, flat spots, yel­low or brownish-yellow in color, usu­ally appearing on the chest, shoulders, armpits, and abdomen. The patient has an odd speckled appearance. The disease is discussed here, not because it is serious, but because it often wor­ries people who do not understand its nature. The spots are covered with small dry scales, which are not always plainly visible. They may grow in size until they are an inch (2.5 cm.) or more in diameter. When they are nu­merous, they may grow together and form large, irregular patches. The skin of the affected spots will not tan.


This disease has no symptoms but mild itching, does not affect the gen­eral health, and is only slightly conta­gious. It is possible, however, to be re-infected by wearing underwear that has not been sterilized. People who sweat considerably are more prone to this disease and to having recurrences.

What to Do

1. Twice a day, wash the affected skin vigorously with soap and warm water, dry thoroughly, and apply a 10 to 15 percent solution of sodium thiosulfate in water, letting it dry on.

2. At bedtime, apply Whitfield's ointment thinly or a sulfur ointment like Pragmatar.

3. Griseofulvin has no use in this condition. Also to go to a doctor is usually unnecessary if one recog­nizes this rash for what it really is.

Inflammatory and Allergic Diseases

ANGIONEUROTIC EDEMA.

Angioneurotic edema is character­ized by rapidly developing, extensive swellings, usually affecting the lips, eyelids, or ears, but not limited to these parts of the body. The swellings —similar to those of hives, but larger and more persistent—are accompanied by itching, burning, tension, and stiff­ness in the affected parts. They are caused by internal or external contact with some substance to which the per­son concerned is sensitive, though the identity of this substance cannot al­ways be determined. They may lead to death by suffocation if they involve the larynx. Much that is included in the discussion of hives also applies to an­gioneurotic edema.

What to Do

1. If the affected areas are acces­sible, bathe them frequently with cool, thin starch water or a strong solution of baking soda.

2. Follow the advice given under Hives, "What to Do," (1), (2), (3), (6), (7), and (8).

3. Ephedrine sulfate by mouth or adrenalin or cortisone by injection may be needed in severe cases; but such remedies require the supervi­sion of a physician.

CHAFING (INTERTRIGO).

Intertrigo is a chafed patch of skin —red, moist, and somewhat raw in ap­pearance, and characterized by smart­ing and burning sensations. It most of­ten affects chubby children and fleshy older people. The rubbing of two skin areas together is the usual cause, but clothes rubbing on the skin can pro­duce a similar effect. In some cases the smarting and burning become severe enough to amount to actual pain. Fail­ure to keep the skin, especially folds in the skin, free from dirt and decompos­ing sweat makes chafing almost cer­tain, particularly in warm weather. It is far better to prevent the condition. than to make treatment necessary be­cause of neglect. If the skin areas likely to become chafed are kept clean, dry, and well powdered, intertrigo will rarely develop.

What to Do

1. Carefully clean the affected skin areas with a soft cloth and warm water. Use a little mild soap at first, if necessary, but rinse all of it off carefully. Dry thoroughly, and apply a suitable powder liberally. A powder made of equal parts of tal­cum and zinc stearate, or of starch and zinc oxide, will usually be effec­tive. Powders act as a lubricant and facilitate the movement of skin over skin. If the afflicted person is an in­fant or a young child, great care should be taken to prevent inhala­tion of any of the powder, particu­larly that containing zinc stearate.

2. If the affected areas are located where one rubs on the other, it may be necessary to keep them separated by cotton pads dusted thickly with powder. As far as possible, avoid any activity which produces rubbing.

3. In persistent cases, the treat­ment recommended under Ring­worm of the Groin in the section on Fungous Diseases may be effective.


CHILBLAINS.

Chilblains are dark red or purplish inflamed areas of skin, usually on the feet, hands, face, or ears. They are caused by frequent or long-continued exposure to cold not severe enough to cause freezing of the tissues, together with a naturally sluggish circulation. They cause much discomfort from itch­ing, smarting, and burning. With con­tinued or repeated exposure to cold temperatures after chilblains have de­veloped, ulceration, scarring, fibrosis, and atrophy of the affected tissues may occur.


The best plan is to prevent chil­blains by protecting the susceptible parts of the body from exposure to cold, and by treatments that will stim­ulate the circulation, especially in those parts. After chilblains have once de­veloped, it may take long treatment to bring about a cure; and subsequent ex­posure to cold is especially likely to cause a recurrence.

What to Do

1. Avoid vigorous rubbing or massage. Keep the affected parts dry, but not too warm. Wear enough clothing, or use any other practicable method, to prevent further chilling.

2. Immediately before bedtime, give alternate hot and cold baths or compresses to the parts for twenty minutes, dry thoroughly, massage gently with olive oil, and apply the following ointment:


Ichthyol .............................3|

Lanolin .............................27|


3. Try to improve the general cir­culation by taking regular exercise and by taking a brief cold bath or shower every morning, followed by a brisk rub with a coarse towel.


DANDRUFF.

DRUG RASH (DERMATITIS MEDI­CAMENTOSA).

Drug rash is caused by sensitivity to some drug being taken at or just before the time when the condition manifests itself. There are more than a hundred drugs known to produce rashes in peo­ple sensitive to them. Drug rashes are great imitators, and the rashes may look like skin eruptions from other causes. Suspicion of a drug rash is jus­tified if a person, as far as can be determined, has no disease characterized by a rash, and at the same time is tak­ing a drug. An investigation should be started at once to determine the true nature of the rash.

Among the common drugs that fre­quently cause rashes are: acetanilide, aminopyrine, arsenicals, barbiturates, bromides, chloral hydrate, ephedrine, iodides, novocain, penicillin, phenace­tin, phenolphthalein, quinine, salicy­lates, various sulfas, turpentine, and many trademarked preparations the constituents of which may be un­known.


Many of these drugs or their compounds are often taken without a physician's advice or knowledge; so if a physician is called to look at a rash, be sure to tell him if the person con­cerned is, or recently has been, taking a drug and, if so, what drug it is.


What to Do

Stop the use of the drug that may be causing the rash. It may be neces­sary to consult a physician to deter­mine the true cause of the rash. Drug rashes vary so greatly in appearance that they are often hard to recognize, and the rash suspected of being caused by a drug may be from some other cause. In some cases of proved drug rash further treatment is needed after the drug is discon­tinued. No simple, general treatment will fit all cases.


ECZEMA (ATOPIC DERMATITIS).

Eczema is an inflammatory but non­contagious condition of the skin, char­acterized by itching, burning, and redness. Some medical authorities con­sider eczema a group of related dis­eases rather than one disease. Others include in the group any inflammatory skin eruption of unknown cause, and there are many cases of skin disease in this category. The eruption tends to appear chiefly on the face, neck, up­per trunk, and in the bends of the el­bows and knees. It is common at ages up to twenty-five.


Typical eczema begins with the "ery­thematous" stage, with itching, burn­ing, and redness of the skin. Then, in the "vesicular" stage, blisters form on the reddened skin areas, some or all of which may become filled with pus, bursting early and allowing clear or pussy fluid to ooze out. During such oozing the disease is often called "weeping" eczema. Usually the blisters or pustules tend to dry down into scales or crusts. The dry-scaly stage is likely to persist a long time. In any stage, the affected skin areas usually have ill-defined borders. Considerable itching and burning are unpleasant symptoms present throughout the course of the disease.


Among the local causes of eczema are such things as the following: chem­ical 'irritants, including dyes, antisep­tics, strong soaps, and contact with plants; thermal irritants, including cold, strong wind, and the sun's rays; me­chanical irritants, such as scratching, friction, pressure; and the action of parasites. Some constitutional condi­tions that may prepare the way for eczema are these: emotional or mental strain, insufficient rest, errors in diet, indigestion, faulty elimination, lowered body resistance, inflammation of the kidneys, and diabetes.


In many afflicted people there seems to be a peculiar individual skin sensi­tivity, often hereditary in nature. It can sometimes be detected by a series of skin sensitivity tests; but these fail more often than not. A careful study of the patient's personal and family his­tory is more likely to disclose the cause or causes. Food sensitivity is an occasional cause of eczema in infants, but this sensitivity tends to become much less marked in later years.

Eczema may be checked or cured in any of its stages, but any of its stages may also prove chronic and persistent. For these reasons the disease appears in many forms. There are three aims in treatment: (1) to correct the causes as far as they can be detected and cor­rected, (2) to soothe the skin in the acute or inflamed stages or forms, and (3) to stimulate the skin to heal in the chronic stages or forms.

This stimula­tion, however, should always be mild. The use of harsh or irritating remedies does more harm than good. Hundreds of remedies for eczema have been rec­ommended, but no single remedy has proved really effective in more than a small fraction of cases. This most com­mon of all skin diseases remains, to date, a persistent nuisance to its vic­tims and a knotty problem for their physicians.


What to Do

1. Regulate the bowels, preferably by eating plenty of vegetables and fruits and drinking plenty of water rather than by the use of cathartics. It is best, however, to avoid eating citrus fruits, strawberries, and toma­toes, because many people are more or less sensitive to one or more of these items.

2. Eliminate any food from the diet which experience has proved hard to digest. Make a careful search with the aid of a physician if pos­sible for any foods or other sub­stances to which the afflicted person may be internally or externally sen­sitive.

3. It is advisable to try eliminat­ing from the diet candy, pastries, sweets, chocolate and cocoa, fried foods, seafoods, pork, milk, eggs, fish, shellfish, and all or nearly all salt.But one should remember that, ex­cept in infancy, food is probably no more than a minor factor either in causing or in curing eczema.

4. Do not use tea, coffee, or alco­holic beverages.

5. Use as little water and soap or detergents on the affected skin areas as possible. It is better to cleanse them with olive oil, especially when it is desirable to soften the crusts.

6. If the hands are affected, it is wise to wear rubber gloves when they must be put into water or soap­suds.

7. As far as possible, avoid over­work, worry, loss of sleep, lack of exercise, or any other practice that will lower physical, mental, or emo­tional vigor.

8. In the acute stage of eczema, ei­ther the erythematous (itching) or the vesicular (weeping) type, try wet dressings or a lotion in the daytime and a powder at night. For wet dressings, use Burow's solution di­luted with 15 to 20 volumes of wa­ter. For the lotion, mix equal parts of olive oil and the standard cala­mine lotion. For the powder, use the following:

Boric acid powder ....................... 2|

Zinc oxide ...................................10|

Talcum powder ..........................18|

9. If the erythematous (itching) stage persists more than two weeks, or if the vesicular (weeping) stage dries down into a reddened swelling with little or no crusting, apply a suitable ointment freely three times a day. One of the following may be used:



I

Salicylic acid ........................1|

Zinc oxide ..........................12|

Starch ................................12|

Petrolatum .......................25|



II

Ichthyol ...........................1|

Zinc oxide .......................8|

Petrolatum ..................20|

10. In the scaly or crusted stage, some stimulating ointment is usually the best treatment. Try either of the following twice a day:

I
Salicylic acid ............................1|

Coal tar ....................................2|

Zinc oxide ..............................25|

Petrolatum ............................90|

If this proves nonirritating after a week's use, the proportions of tar and salicylic acid may be gradually increased until they are double.

II

Resorcinal ...............................1|

Powdered sulfur ....................3|

Hydrous wool fat ................30|

White wax ..............................4|

Petrolatum ..........................30|


If this proves nonirritating after a week's trial, the proportion of res­orcinol may be gradually increased until signs of mild irritation appear.

11. Make every reasonable effort to consult a skin specialist, especially in the case of a baby with eczema. This disease is frequently so resistant to treatment that special remedies may be needed, some of which can­not be secured without a physician's prescription. (This may be true also of the above prescription containing resorcinol.)


ERYTHEMA MULTIFORME.

Erythema multiforme is an acute, in­flammatory condition of the skin, char­acterized by flat or raised spots of a reddish color, commonly affecting the backs of the hands, the upper surfaces of the feet, the face, the sides of the neck, and sometimes the legs and the backs of the forearms.


It occurs most commonly in the spring or the fall, and young adults are most often attacked. The eruption develops within twelve to twenty-four hours, the spots of various sizes being accompanied by little or no itching or pain.


There may be head­ache, backache, and some fever. The flat or elevated spots may develop into blisters and pustules, which sometimes become ring-shaped. Pressure on a spot with a fingertip will cause the red color to fade, but it returns quickly when the pressure is released. Within ten to fourteen days, the red color changes to a faint purple, and eventually all ab­normal color disappears, leaving no scars.


Erythema multiforme rarely attacks a person in good health. It is most of­ten observed on the skin of people who have rheumatism, some acute or chronic infection, sensitivity to certain foods or drugs, or a general run-down condition. In some people, damp and chilly weather seems to bring out the eruption.


The remedies that may prove useful depend on the underlying causes. Since these causes may vary so widely, a course of treatment suited to one pa­tient may do another very little good. All but the simplest cases, which show prompt improvement when a good hy­gienic program is begun, should if pos­sible be carefully studied by a physi­cian, who can recommend treatment aimed at the correction of general de­bility or any other specific condition revealed by his study as a possible cause of the skin eruption. No local treatment does much good, as a rule, and the care of blisters or pustules and the giving of some of the treatments which many erythema multiforme victims need are best left in the hands of an experienced physician.


What to Do

1. Try an elimination diet. Do not eat eggs, wheat products, or cow's milk in any form. For cow's milk, substitute goat's milk or soy­bean milk, preferably diluted. For wheat foods, substitute cornmeal mush, other foods made from corn, or rye crisp. Eat oranges, grape­fruit, prunes, plums, apples, pears, and bananas, or drink fruit juices. As vegetables, use peas, lettuce, squash, string beans, carrots, potatoes, and asparagus. Substitute margarine for butter. Drink at least two quarts (liters) of water and juices every day.

2. Avoid the use of tea, coffee, and alcoholic beverages.

3. Rest in bed as long as any fe­ver is present.

4. Daily starch baths may be use­ful. Use one or two cupfuls of starch per tub of water. Boil the starch for five minutes in ten parts of water before adding to the bath water, which should be warm. The bath may be continued for fifteen min­utes, but somebody should constantly watch the patient for possible signs of fainting.

5. For local applications, follow the directions given under Eczema, "What to Do," (8) and (9).

ERYTHEMA NODOSUM.

Erythema nodosum is an acute in­flammatory skin disease, marked by very tender red nodules which appear in successive crops, usually on the front surfaces of the legs but sometimes on the forearms, accompanied by intense itching and burning sensations. The nodules are from one-half inch to two inches (1.2 to 5 cm.) in diameter. Their appearance is often accompanied by mild fever, a general feeling of lack of energy, and rheumatic or joint pains. On careful examination, a patient who develops erythema nodosum will usu­ally be found to have infected ton­sils, rheumatism, tuberculosis, valley fever, or some other infection needing medical care. This makes it doubly im­portant to consult a physician, if possi­ble, as soon as the characteristic erup­tion appears.

What to Do

1. The patient should take no ex­ercise for at least two weeks, and if possible should stay in bed.

2. The bowels and kidneys should be kept active, preferably by means of suitable diet and abundant fluids.

3. Local applications of any kind will not do much toward curing the condition, though they may reduce the discomfort. An ointment made according to the following prescrip­tion may be applied liberally to the nodules three times a day:

Ichthyol........................ 3|

Lanolin ........................27|

4. Have a thorough medical ex­amination to detect if possible the underlying cause of the skin condi­tion. It may well be some infection or disease which itself needs treat­ment.

EXFOLIATIVE DERMATITIS.

Exfoliative dermatitis is not a spe­cific skin disease, but an inflammatory condition of a serious nature, charac­terized by a reddening and scaling or peeling of much of the skin surface, and accompanied by fever and various other signs or symptoms of general ill­ness. The name means an inflamma­tion of the skin resulting in the peeling off of pieces of considerable size. Sometimes the patient loses the whole outer layer of the skin before the attack sub­sides.

Because of the variety of possible causes, no definite group of symptoms characterizes the condition. Neither is there any characteristic appearance, though rather large blisters and pus­tules are found in many cases. In others there may be at first a severe red­ness and a burning sensation in com­paratively large skin areas, followed a few days later by the aforementioned peeling.

Bacterial or fungous infections, spread of psoriasis, seborrheic dermatitis, toxic effects from arsenicals or other drugs, dietary upsets, malignant diseases of lymph and blood-forming tissues, vi­tamin deficiences, external irritants, or any one of several other possible condi­tions may lie at the root of the skin in­flammation that is the first step of this disease. Obviously it is the underlying condition that needs the most atten­tion, and applications of lotions or oint­ments to the skin can do little more than help relieve itching or other un­pleasant sensations. Since, however, the condition can become rapidly worse and put life in peril, expert attention should be sought as soon as exfoliative dermatitis seems to be developing. Do not waste time in trying to see what lo­cal applications will do.

What to Do

Without delay, consult a derma­tologist or experienced physician. Hospitalization is often advisable.


HIVES (NETTLE RASH, URTICARIA).

Urticaria is caused by a poison within the body or by one attacking it from the outside. The poison causes the small blood vessels to dilate, and fluid oozes out of them into spots on the skin which become swollen and itch violently. The swollen spots look somewhat like those which result from con­tact with nettles or from insect bites or stings.


The area around one of these spots is usually slightly reddened, but the spot itself appears almost white. A typical spot is from one-quarter inch to one inch (.6 to 2.5 cm.) in diameter, but it may be larger. Lasting from a few minutes to several hours, the spots disappear, leaving no trace; but others may quickly follow. Scratching, with its temporary relief from itching, produces irritation and usually leads to the ap­pearance of additional and more severe swellings.

The poison which causes urticaria is rarely a substance poisonous to every­body, but one to which the individual concerned is especially sensitive. The commonest source of these special poi­sons is food. For this reason one aim in treatment should always be to clean out the intestinal tract by administra­tion of a cathartic.

What to Do

1. Try to learn the cause of the attack, and if possible avoid it in the future.

2. Take a tablespoonful of Epsom salts or of castor oil as a cathartic.

3. To allay itching, apply a strong solution of baking soda to the af­fected skin areas freely every two hours, or apply small amounts of a 10 percent solution of menthol in al­cohol as often as desired. Sometimes the following prescription applied freely is effective:


Thymol ................................1|

Glycerin ..............................8|

Alcohol (95%) ................110|

Water .............................100|



4. Avoid the use of tea, coffee, and alcoholic beverages.

5. Avoid eating foods to which you may be sensitive, for example: fish, shellfish, pork, cheese, choco­late, citrus fruits, garlic, melons, mushrooms, onions, pickles, straw­berries, or tomatoes.

6. If repeated or long-continued attacks occur, consult a physician.