Skin Diseases (3)

LICHEN PLANUS.

Lichen planus is an inflammatory skin disease characterized by small, fre­quently angular, violet-colored, raised spots with flat, shiny tops, occurring singly or in patches, and appearing chiefly on the flexor surfaces of the wrists, on the ankles, genitals, and lips, and on the mucous membranes of the mouth or vagina.

In some cases the eruption may appear elsewhere, or even become generalized, but the face and scalp are rarely attacked. If the rash is found on one limb or one side of the body, the opposite limb or side of the body will also show it. Sometimes the mucous membranes only are af­fected. Cases are not uniform in ap­pearance. Spots on mucous membranes are characteristically covered with a lacy network of white lines.

Though the onset is sometimes grad­ual and the course chronic, in the typi­cal acute case of the disease there is usually a general feeling of illness im­mediately before the rash begins to ap­pear. Then within one or two days the eruption is complete, the slightly raised, red or light-purplish spots usually caus­ing intense itching.

The exact cause of lichen planus re­mains unknown, but it is believed that mental or physical strain or a general run-down condition may give rise to it. It may be accompanied by a considerable degree of general debility, and it will often call for the attention of a skin specialist for recognition as well as treatment.

What to Do

1. Give the patient the benefit of good, plain food, hygienic living, and, when possible, outdoor life with freedom from worry or care.

2. Apply the following lotion fre­quently and remove it by using any convenient kind of oil.


Sol. coal tar ......................12|
Zinc oxide ........................24|
Starch ...........................24|
Glycerin ..........................36|
Water q.s. ad ..............120|

3. In severe or persistent cases, consult a skin specialist, who can give more effective treatments as needed.

LICHEN SIMPLEX CHRONICUS (LOCALIZED NEURODERMA­TITIS).

Lichen simplex is a chronic skin dis­ease characterized by a slight inflam­mation but much itching. The eruption occurs in comparatively large patches, of which there may be from one to sev­eral present on the back of the neck, the inner surfaces of the thighs, the external genital organs, the ankles, eye­lids, and ear canals.

The affected skin areas are dry, thickened, leathery, and pigmented. The condition may be a late stage of any chronic or irritative skin inflammation, or it may develop on normal skin. It often affects people of Oriental extraction and women past forty. Scratching gives temporary re­lief, but the itching is likely to return later in a more intense form. The itch­ing causes the skin to swell, and this produces more itching. The disease tends to be very persistent, but it may disappear from one area without any apparent reason, only to appear in an­other.

What to Do

1. Avoid stress or emotional up­sets.

2. Avoid scratching the affected areas.

3. Avoid the use of soap.

4. Try applying the following lo­tion four times a day:

Menthol.................... 1|
Phenol ..................2|
Glycerin .................15|
Alcohol, 35%, q.s. ad ..............240|

5. Consult a skin specialist if pos­sible. The most effective treatments or remedies cannot be given in the home or by people without medical training.

LUPUS ERYTHEMATOSUS.

Lupus erythematosus is a chronic, nontuberculous, inflammatory disease of the skin, characterized by dusky red disklike patches, which do not tend to form nodules or ulcers. The patches are covered with dry scales and crusts which tend to adhere; but if they fall off, they leave dull-white scars.

The patches have definite borders. They may include one or more small scarred areas, in which enlarged and empty hair follicles can be seen. The right and left sides are usually both affected, and about equally. The nose, cheeks, and ears are most often affected; and the most characteristic distribution is in a "butterfly" pattern. The eruption may sometimes appear on the scalp or the arms.

This disease usually begins after pu­berty and before age thirty, but it tends to persist throughout the remainder of life if not successfully treated. Its causes are not definitely known. It has been observed to develop following sunburn, the external factor being ex­posure to sunlight.

Chronic infections apparently help to cause it in many cases. An occasional acute case, where the eruption spreads rapidly over a considerable area, may be associated with a hidden or general infection and may prove fatal. As a rule the chronic disease is not accompanied by a feel­ing of illness, and rarely by any dis­comfort. It is persistent, and because long and faithful treatment is required for a cure, in no case can a cure be guaranteed.

While the chronic form is rarely a menace to life, it is the cause of some physical and much mental dis­tress, chiefly on account of its looks and scarring.

Rarely, lupus erythematosus occurs in a disseminated form, either before, during, or after the appearance of skin manifestations, with a great variety of acute symptoms due to the involvement of many different organs and sys­tems. This variety of the disease tends to prove fatal, but the attacks are likely to present such distressing symptoms that a physician is almost certain to be called. Even the best physician, how­ever, may find it a difficult diagnostic problem and an ailment hard to treat.

What to Do

1. Live a hygienic life, giving care­ful attention to a simple diet, abun­dant in vitamins, especially vitamin B complex. For potatoes, substitute white or brown rice, noodles, maca­roni, spaghetti, or barley. Avoid tea, coffee, chocolate, spices, tobacco, and alcoholic liquors, especially beer. Drink coffee substitutes or milk.

2. Avoid exposure to sunlight and all strong light, and take no X-ray or light treatments.

3. For the first few days, apply 1 percent phenol in calamine lotion three times a day. Later, use this lo­tion morning and noon and apply lo­tio alba at night. Remember, how­ever, that no ordinary remedy is likely to be curative.

4. A dermatologist may prescribe antimalarial drugs, cortisone liquids and creams, or other remedies im­possible or unsuitable for use in home treatment.

PEMPHIGUS.

Pemphigus is an acute or chronic skin disease characterized by blisters which appear on the skin and mu­cous membranes. These develop sud­denly, often on apparently normal skin, and are accompanied by constitutional disturbances of varying severity and by itching and burning sensations.

The blisters may vary in size from that of a pea to that of an egg. Their number varies from a few to scores, and they may appear singly or in crops. The walls of the blisters are thin and tense, and they enclose a clear fluid similar to blood serum. This fluid later becomes turbid or bloody.

When a blister breaks, a crust usually forms. The blis­ters may also appear on the mucous membranes of the mouth, throat, or va­gina. Sometimes they are intermingled with other types of skin eruptions, which may for a time make diagnosis difficult; but eventually the blisters be­come so prominent a part of the picture that the true nature of the disease be­comes evident.

Without proper treatment, pemphi­gus is almost always fatal. Its course may extend over several months or even years, or it may end in death within a few weeks. This is especially true of a very severe form of the dis­ease well known in the central part of South America, where it is called fogo selvagem, which makes its victims more miserable than almost any other malady they could possibly have. Fogo selvagem (savage fire, or Brazilian wildfire) differs from other forms of pemphigus in that it frequently attacks youth and even children.

The acute form of pemphigus may be caused by some infective agent, pos­sibly a virus, but the identity of this agent remains unknown, and it may not be the same in all cases. The chronic form is believed by some authorities to be of intestinal origin, but there is in­sufficient proof of this theory. Pemphi­gus is a disease of adult life, and it of­ten affects Hebrews and people of Eastern European extraction.

What to Do

1. If pemphigus is suspected, seek expert medical help at once. Life may be in danger, and home reme­dies or treatments alone have no chance of success.

2. Try to build up the general health. Take a liberal diet, rich in vitamins, especially vitamin D. Take plenty of rest. In severe cases, rest in bed on an air or water mattress may be necessary.

3. Carefully open the blisters and let out the fluid. Then dust the af­fected skin thickly with the follow­ing powder:

Zinc stearate ...............20|
Powdered starch ...............20|
Talcum powder .....................20|

Mix thoroughly

4. Soak or bathe the affected skin areas of the patient in a 1:5,000 so­lution of potassium permanganate in water for at least an hour every day.

5. Cortisone is the most effective remedy for pemphigus and may even be lifesaving. Of course its use must be carefully supervised by a physi­cian.

NOTE —In the Penfigo Adventist Hospital of Campo Grande, Mato Grosso, Brazil, pemphigus is treated with a medicine called Jamarsan. This treatment effects a cure in about 77 percent of the cases.

PITYRIASIS ROSEA.

Pityriasis rosea is an inflammatory disease. It is sometimes classed among the virus diseases because it runs a definite course of about six weeks and seems to build up an immunity, but the virus has not been definitely discov­ered.

Second attacks are rare. It is not contagious. It will subside of itself eventually, in three to six months, even if untreated. It deserves attention here chiefly for two reasons: (1) It is fairly common, and (2) those who have it may fear that it is something serious. Unrelieved fear may do more harm than the disease itself.

This disease manifests itself as nu­merous small, oval, yellowish or fawn-colored, sometimes pinkish or reddish, slightly scaly spots or patches, scat­tered over more or less of the trunk and those parts of the limbs adjacent to it. As a rule, a single comparatively large patch appears first somewhere near the waistline. This is called a herald or mother patch. The general eruption comes a week or two later. The long diameter of the patches lies in the di­rection of the natural wrinkles of the skin.

Dry, crinkly scales usually form on the patches, beginning in their centers. The larger patches may clear in their centers, forming rings, which are not, however, raised as much at the edges as are those of ringworm of the body, with which it may be easily confused. Mild itching is usually the only symptom, and the eruption disappears in a matter of weeks or months, leaving nei­ther scar nor any other sign of perma­nent damage. In fact, the symptoms are so mild and the ordinarily visible parts of the skin surface so rarely affected that the eruption may be present for several days before its presence is no­ticed.

What to Do

1. If pityriasis rosea is suspected, consult a skin specialist if possible, not because the disease is serious, but for two other reasons: (1) The erup­tion somewhat resembles that of other more serious diseases, and its true nature needs to be known. (2) A short course of cortisone, administered by the physician will usually clear up the eruption promptly.

2. If the eruption is noticeably un­comfortable, which is not often true, use starch baths, mixing one to two cupfuls of Linit starch to a tub of bath water.

POISON IVY (CONTACT DERMA­TITIS, POISON OAK).

What we are discussing here is an acute inflammation of the skin, typical cases of which are caused by contact with poison ivy or sumac in the East and poison oak in the West. There are other plants in other parts of the world that cause similar skin inflammation by contact, and there are substances other than plants that may cause a similar in­flammation.

The inflamed, swollen, and intensely itching skin areas, thickly covered with tiny blisters in the early stages, are so familiar to most people that recogni­tion of the condition is often easy. Characteristically there are linear blis­ters associated with scratch marks.

The substance causing ivy or oak poisoning is a waxy or resinous material which can be dissolved by strong soapsuds or rendered harmless by strong oxidizingagents. Extracts of poison ivy or poison oak have been prepared for use as vac­cines. These vaccines seem to have af­forded some protection to a number of people, but for others they have proved useless.

There are so many substances caus­ing inflammation of the skin by contact that it is impossible to discuss them all here. Some affect a large proportion of all persons exposed to them, while oth­ers only occasionally cause trouble. It is usually a matter of individual sensi­tivity to the particular material in ques­tion.

Fur, feathers, leather, various dyes, some of the plastics, and numer­ous drugs and chemicals are common offenders. The effect may vary from a slight and temporary reddening of the skin with mild itching to a severe in­flammation with blisters and pustules that may not clear up for months.

Skin specialists always keep in mind the possibility of contact dermatitis when a puzzling skin eruption comes to their attention. The same treatments and preventive measures are of value in most cases of this type of skin inflam­mation. Avoiding further contact with the offending substance is obviously the most important preventive mea­sure.

What to Do

1. If contact with the offending poison is recognized within a few minutes of the time it occurs, much of the poison can be removed or de­stroyed by washing the endangered skin areas with strong soapsuds, or by painting them with a 1:500 solu­tion of potassium permanganate in water. Later, avoid the use of soap. (Note: The recommended perman­ganate solution is a strong one, and it may deeply, though not perma­nently, stain the skin.)

2. During the stage of blisters and oozing, use cold (never hot) wet dressings as much of the time as practicable. For the dressings, use eight to ten layers of gauze, fluffed and crumpled, then wet with one or other of the following solutions: (1) saturated solution of aluminum ace­tate (Burow's solution) diluted 1 to 15, (2) saturated solution of mag­nesium sulfate (Epsom salts), or (3) 1 percent solution of zinc sulfate. Ap­ply the wet dressings over the entire affected skin areas, cover with waxed paper, oiled silk, or plastic to keep in the moisure, and bind on snugly with bandages. The dressings should be kept wet, and the room kept warm enough to protect the patient from chilling.

3. When the blisters have dried and the oozing ceased, apply 1 per­cent phenol in calamine lotion three times a day.

4. As a preventive measure before going into places where there is dan­ger of contact with poison ivy or poison oak, apply to the skin a van­ishing cream to which 5 percent of sodium perborate powder has been added. If you must stay in such a place very long, wash away the medicated cream and make a fresh application about every three hours.

PRICKLY HEAT (HEAT RASH).

Prickly heat is characterized by a red rash with many very tiny blisters ap­pearing on the skin surface, most often affecting babies and stout per­sons, particularly those of fair com­plexion.

The name is well descriptive of this familiar condition, for the skin feels both prickly and hot. The chief external causes of the rash are hot weather and the wearing of too much or too warm clothing. The use of alco­holic liquor encourages prickly heat to develop.

With proper treatment, the rash should clear up in a week or less; but in severe cases with a large part of the body surface involved, body tem­perature regulation may be interfered with because the sweat gland outlets may have been damaged, and there may be a fatal outcome.

What to Do

1. Avoid the use of soap in cleans­ing the affected skin areas. Use thin starch water instead.

2. Apply the following lotion four times a day:

Menthol .......................1|
Phenol .......................2|
Glycerin .....................15|
Alcohol, 35%, q.s. ad ................240|

3. Keep the affected areas cool and dry, as far as possible. When the acute stage of the rash is past, keep these areas thickly dusted with corn­starch.

4. If the causes of prickly heat cannot be avoided, dabbing on a small amount of a 10 percent solu­tion of tannic acid in alcohol twice a day may toughen the skin and help prevent further attacks; but this does not always succeed, and should never be done for more than a week at a time.

PSORIASIS.

Psoriasis is sometimes an acute, but much more often a chronic, inflamma­tory skin disease, characterized by dry, well-defined, reddish patches, fairly large and covered with an abundance of silvery scales. The patches are most commonly found on the scalp, the knees, the elbows, or the sacral region. Much of the trunk, however, may be involved, and, in severe cases, no part of the body surface is exempt from the eruption.


The silvery scales which characterize this disease keep falling off continually a fact which helps in its recognition. If the scales are rubbed off forcibly, blood may ooze from "bleeding points" on the inflamed skin beneath.

No clear evidence exists that psoria­sis is infectious, and it is not conta­gious. Sometimes mild itching accom­panies this disease, but it does not cause any feeling of general illness. It is often worse in cold seasons.

While usually chronic and persistent, psoria­sis will sometimes disappear for some time without treatment, though usually recurring later.

Many ointments, lotions, and other remedies have been recommended for the treatment of psoriasis, but as yet none of them has succeeded in bring­ing about more than temporary improvement or relief. General improve­ment in health habits offers the most hope for the psoriasis victim, but X-ray and quartz-light treatments are often helpful.

What to Do

1. Take a low carbohydrate diet. Avoid tea, coffee, tobacco, and espe­cially alcoholic beverages. Avoid ex­posure to cold.

2. Eat freely of fruits and vegeta­bles. Be sure that the diet contains an abundance of vitamins. To obtain enough of vitamins A and D with­out taking too much fat or oil, some rich source of these vitamins, such as halibut-liver oil, should be taken in moderate amounts.

3. If constipation is present, do not use mineral oil to control it.

4. In any possible acute stage, avoid all irritating applications. The following lotion can be recom­mended for use twice a day or of­tener:

Cornstarch.................. 24|
Zinc oxide................. 24|
Glycerin ....................12|
Limewater q.s. ad ................. 120|

5. After the acute stage is past, or in any ordinary subacute case which has no acute stage, remove the scales from the spots by using warm water, mild soap, and a soft brush. Avoid causing any considerable amount of bleeding. Then every evening apply 3 percent crude coal tar ointment or the following lotion:

Sol. coal tar.............. 12|
Zinc oxide .............24|
Starch ............. 24|
Glycerin ..............36|
Water q.s. ad ...............120|

In the morning, scrub or wash away any remnant of the ointment or lotion.

(Caution: If the eruption is on the scalp, apply nothing but 5 percent ammoniated mercury ointment.)

6. In the chronic stage, apply 5 percent ammoniated mercury oint­ment twice a day.

7. In either the subacute or the chronic stage, expose the affected skin areas to sunlight as much as possible, avoiding sunburn, and re­membering that prior use of tar-con­taining preparations increases the sensitivity of the skin to sunlight. After exposure to sunlight, soften the skin areas with a little olive oil.

8. X-ray or quartz-light treatments may be very beneficial, but they must be given by, or according to the or­ders of, a physician; and he may be able to prescribe other useful reme­dies.

9. Remember that psoriasis is sel­dom really cured, but can often be controlled.


SAVAGE FIRE.

SEBORRHEIC DERMATITIS (DAN­DRUFF).

Seborrheic dermatitis is a very com­mon affliction, characterized by mild itching and free oily scaling, usually found on the scalp, but sometimes af­fecting the face, neck, chest, armpits, groins, or genital regions. It is included in the list of inflammatory skin condi­tions, first, because of its outward re­semblance to certain other inflamma­tory conditions, second, because of a constant though very mild inflamma­tion of the skin, and, third, because no proof exists that any infection is pri­marily involved.

Called "dandruff" when located on the scalp, it is so common that few peo­ple are completely free from it. When it appears on the body elsewhere, the eruption is more likely to be character­ized by more or less oily crusts instead of dry scales. The skin beneath the crusts is somewhat thickened and mildly inflamed. The only unpleasant sensation is the mild itching.

A hereditary tendency, hormone im­balance, nutritional states, and emo­tional stress are possible causative factors. If any factor of infection is in­volved, it is probably secondary, and the causative organism or organisms cannot yet be definitely classified as ei­ther bacteria or fungi. Seborrheic dermatitis tends to persist for a period of years, though it may come on in successive attacks, each of which may last from weeks to years.

What to Do

1. Take a diet low in fats, sweets, starches, spices, and hot drinks.

2. Try to build up the general health by means of a program of all good health habits, including proper diet.

3. Take some standard preparation of vitamin B complex, preferably one containing an ample proportion of vitamin B.

4. If possible, have a basal metabo­lism test made. If the metabolism is much below normal, take thyroid tablets as directed by a physician. Do not take them on your own re­sponsibility.

5. For "dry" dandruff on the scalp, proceed as follows:

Shampoo three times a week for four weeks afterward once a week until a satisfactory cure is accom­plished. Once a week, at bedtime, after a shampoo, apply Pragmatar ointment, which contains salicylic acid and sulfur and is available at any drugstore.

The following morning, wash away all traces of the ointment with mild soap and warm water, massag­ing the scalp well. After the wash­ing and massage, rub into the scalp a little of the following lotion:

Phenol ............. |5
Castor oil .................1|5
Salicylic acid 2 Alcohol, 70% q.s. ad...................... 120|

6. For "oily" dandruff, proceed as in (5) above, but make the morning washing rather brief and avoid all massage.

7. Though the condition is not primarily infectious, germs may bepresent and may make the condition worse, so sterilize your comb at least once a week. Use no hairbrush, be­cause a hairbrush cannot be steri­lized.

8. If the skin of the face or the body is affected, try the following:

Alternate nights at bedtime, rub in 5 percent sulfur ointment.

On the in-between nights, apply lotio alba.

9. X-ray or quartz-light treat­ments given by a skin specialist may be beneficial to change the chemistry of the skin and to discourage the growth of any bacteria that may be present. Some of the most effective remedies also are obtainable only by a physician's prescription.

SUNBURN.

Sunburn is an inflammation of the skin characterized by burning and red­ness, due to overexposure to the rays of the sun. It needs little discussion; but sometimes one forgets that the red­ness and burning do not develop until some time after the exposure and that sunlight reflected from a glass or wa­ter surface can burn as well as direct sunlight. A person cannot tell by feel­ing alone at the time whether or not he is overexposing his skin. Every expo­sure to the sun produces some damage to the skin, especially to fair-skinned individuals.

Certain diseases that may be pres­ent, and a considerable number of drugs taken orally or applied to the skin, make the skin more sensitive to sunlight. Fair-skinned, blue-eyed peo­ple are more sensitive to it than dark-skinned. Severe sunburn over a large part of the skin surface is more danger­ous than many people realize. It is well to remember that in extreme cases it can cause crippling or even death.

In severe cases involving a large fraction of the skin surface, there is likely to be pain, swelling, blistering with later peeling, a gastrointestinal upset, and considerable fever for sev­eral days. A toxic condition develops, probably because of some decomposi­tion of the deeper skin tissues damaged by the sun's rays. If crippling devel­ops later, it is likely to be the result of stiffening and contracture of damaged tendons. A still later possible effect is permanent hardening of the skin, or even skin cancer.

What to Do

1. Apply continuous wet dressings of a saturated solution of aluminum acetate (Burow's solution) diluted with twenty times its volume of cold water. Continue until the pain and smarting are permanently relieved.

2. A similar effect, may be ob­tained by getting into a lukewarm starch bath, prepared by stirring one or two cupfuls of Linit starch into a tub of bath water.

3. If large areas of skin are in­volved, and if the burning is severe, bed rest and the attention of a physi­cian may be necessary.

4. The following sunburn oint­ment is recommended for applica­tion before exposure to the sun's rays:

Zinc oxide.................. 2|
Glycerin ..................4|
Quinine hydrochloride.................. 6|
Rose water ointment................. 30|

5. Even more protection is af­forded by a heavy coat of standard zinc oxide ointment thickly dusted with talcum powder, but to apply this over large areas of skin is not convenient.

Malformations

HEMANGIOMA (BIRTHMARK, VASCULAR NEVUS).

The ordinary birthmark of reddish or purplish color is composed of a mass or network of tiny blood vessels in the skin. In the simplest case the skin is smooth and normal in every respect ex­cept for the excessive number of the blood vessels in it. In more severe cases, the skin may be thickened or the area may show one or more "blood blis­ters." The birthmark may even be an irregular and unsightly tumor mass of one or more lobes.

The unsightliness, however, is the chief disadvantage. Such tumor masses rarely become can­cerous, but they may occasionally ul­cerate. They do not injure the general health unless they become infected, which does not often happen. As a gen­eral rule, treatment begun early in life is more likely to give satisfactory re­sults than if begun later, so whatever is to be done should not be too long de­layed. A large majority of birthmarks, especially the flat ones, will disappear by age six even if not treated.


What to Do

1. Do not try any home remedies.

2. Skin specialists can use carbon-dioxide snow, electrodesiccation, quartz light with pressure, radium, X rays, cautery, injections, or other methods of treatment that are effec­tive.

ICHTHYOSIS (FISHSKIN DISEASE, XERODERMA).

Ichthyosis is characterized by dry­ness, roughness, and thick, adherent scaliness of the skin. The outer layer or epidermis of the skin is thick and may show numerous shallow cracks, the surface tending to peel in rather large scales. In mild cases there is merely a persistent dryness and rough­ness of the skin surface.

This condition appears early in life, and seems to run in families. Sluggishness of the thyroid gland is found in many cases.

Ichthyosis affects only the outer layer of the skin and does not harm the gen­eral health. In occasional cases, how­ever, the ability to perspire is lessened, and the afflicted person tends to become more readily feverish or over­heated than he normally would. In most cases, the chief disadvantage is the more or less unsightly appearance, but, fortunately, the face, hands, and feet are rarely noticeably affected. Dur­ing warm weather, mild cases will show improvement and the skin may appear practically normal. Dry air and cold weather make the condition worse.


What to Do

1. Do not expect a real cure, be­cause the skin of the affected person is permanently short of sweat and oil glands.

2. Daily, but especially after each bath, apply some bland oil or oint­ment, such as petrolatum, cocoa but­ter, or oil of sweet almonds. Petro­latum to which 1 to 3 percent of salicylic acid has been added has some advantages over plain petrola­tum.

3. Bathing should be restricted, as it adds to the dryness already pres­ent.

4. When a bath is taken, the wa­ter should be soft, preferably water that is naturally soft.

5. Use soap sparingly. It is ad­visable, however, to use it on body folds when bathing.

6. A basal metabolism test should be made under a physician's direc­tion. If it indicates a sluggish action of the thyroid gland, thyroid tablets should be taken as the physician di­rects. Do not take them otherwise.

MOLE (NEVUS).

Moles are usually present at birth or appear early in life. In time they may grow and become considerably larger. In color most of them resemble the surrounding skin. Although they may never make trouble aside from their unsightliness, some of them may be­come cancerous, spreading cancerous cells through the bloodstream to other parts of the body, giving rise to a con­dition that may prove fatal. Moles

which are black, bluish-black, or grayish-blue and flat, especially those lo­cated where they are exposed to irrita­tion, are most likely to become malignant. Any mole which shows signs of irritation or which begins to grow rapidly, whatever its color, should be considered suspicious.

Moles showing any signs or symp­toms suggesting possible developing malignancy should be promptly re­moved. Small moles can often be ef­fectively treated by using an electrical instrument that kills and dries the tis­sue.

What to Do

1. Do not attempt self-treatment.

2. Have a physician, preferably a skin specialist, remove the growth, particularly if it is dark-colored, be­gins to change color or grow, or be­gins to feel tender or irritated. He will know what to do and how to do it.