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Related post: f)f their central portion, become transformed into circinate |
lesions, with elevated red borders, inclosing a sunken-in
yellow space, or, by involution of a portion of the periph-
eries of the latter, there results a crescentic lesion, or one
representing some segment of a circle. These latter, in their
advance and progress over the surface, may join together
and form a gyrate or wreath-like lesion, or one consti-
tuted by a polycyclic border surrounding a yellow center.
5. The slight grades of the disease are dry and pityri-
asic in character, but, as the intensity of Order Captopril the process Order Captopril Online in-
creases, the amount of sealing increases greatly, or points
of weeping, or a moist exudation from an eroded periphery,
or a copious exudation from the entire surface of a lesion,
is seen to occur. In the pityriasic lesions the presence of
an abnormal amount of fat is clinically not noticeable, but
this becomes more apparent in proportion to the severity
of the disease, and may even constitute a marked feature,
the affected portions of the skin being covered with either
small, fatty, soft scales, or large Buy Captopril crusts of the same char-
acter.
6. The slighter forms are Purchase Captopril not always sharply delimited
from the healthy skin, but occur more diffusely. The other
lesions — macules, papules, Generic Captopril discs, etc. — are, however, sharply
defined, and terminate quite abruptly.
7. Thickening of the skin or elevation of the lesions is
seen only in the higher grades of the disease, but is not
apparent in the primary or light stages.
8. The shape of the lesions — papules, discs, etc. — is
round or oval, regular or irregular, circinate, crescentic, etc.
Their color is a pale to a bright red, Purchase Captopril Online a yellowish, yellow-
brown, and even brown — oftener yellow-red.
9. As a rule, the subjective symptoms are limited to
slight itching, especially when the patient is heated; but in
the severer grades the Buy Captopril Online pruritus may become intense and ex-
cessively annoying. At times a burning and tingling sen-
sation is complained of.
The pathology of seborrhoic eczema and the patho-
logical changes which take place in the tissues in its vari-
ous stages are of major importance and Buy Cheap Captopril require particular
description. Inasmuch as this paper is intended, however, to
present only the clinical aspects of the disease, the micro-
scopical portion will be omitted. This has, furthermore,
been judged advisable for the reason that its thorough con-
sideration would require a review also of those conditions —
pityriasis capitis and seborrhcea sicca — from every side, a
work impossible to undertake at present. Their anatomo-
pathology, as well as that of the other forms of seborrhoic
eczema, will be treated ofatanothertime, and I willonly state '
here that the result of the studies made by me of the vari-
ous phases of the disease have led me to the conclusion that
the cutaneous manifestations — pityriasis capitis, etc. — are
only stages and degrees, and constitute an inherent portion
of the same process. This statement, though apparently
somewhat radical, is, however, only in unison with the ob- •
servations to be made every day on cases of seborrhoic j
eczema, and is susceptible of clinical demonstration. In
other words, it can be demonstrated by clinical facts and
evidence alone that such close connection and direct rela-
tionship exists between these conditions — pityriasis capi-
tis, etc. — and those others — macular, papular, circinate, etc.,
Feb. 14, 1891.
ELLIOT: ECZEMA SEBORRHOICDil.
179
simply scaly, or crusting, or weeping lesions, which aro
met with on hairy and non-hairy surfaces, and which are
characteristic representatives of the process eczema scbnr-
rhoicuin — that it is impossible to separate the one from the
other. Certainly the most difficult portion of thequestiou,
this demonstration of the clinical relationship existing be-
tween these primary and slight grades and those more ad-
vanced and severe ones, it is rendered doubly so by the fact
that our text-books inculcate the opinions that the phases
of cutaneous disease termed pityriasis capitis and sebor-
rhoea sicca represent an entity, or are distinct processes
— that is, according to some, each is distinct in nature
and separate from the other, while to others both merge
more or less into each other' or are identical. In conse-
quence, our teaching compels us to approach the Captopril Online subject
with such preformed convictions and prejudicial inclina-
tions that its study from any new standpoint of view is ma-
terially influenced, and it is only a steady accumulation of
facts and of evidence that finally forces us to entertain a
new conception of these processes hitherto regarded as well
and" thoroughly known. This same difficulty was experi-
enced by mvself, and it was only after careful clinical study
of the cases presenting themselves almost daily that I could
divest myself of the opinions previously entertained, and
could conclude satisfactorily that the clinical testimony and
evidence warranted the belief that those objective lesions
on the skin — pityriasis capitis and seborrhoea sicca — were

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