Definition And Description

This form of disease, first accurately described by Hebra, is characterized by an intense redness, diffused over a large part of the skin, or even the whole of it, disappearing beneath the pressure of the finger, and accompanied by the presence of fine, white, loosely adherent scales, which result from the constant shedding of the superficial layers of the cuticle. The affection is attended with but slight pruritus. Its duration is chronic and recovery is doubtful, the cases treated by Hebra having all terminated fatally after a few years. The disease is rare in America.

Diagnosis

The only affections for which it could possibly be mistaken are Eczema or Psoriasis, from both of which the history should bo sufficient to enable it to be distinguished.

Etiology

Unknown.

Prognosis

Bad.

Treatment

On this point Hebra says: "In the cases of Pityriasis rubra universalis which have come under my observation, I have made trial of many of the medicines and plans of treatment, which I have described in detail when speaking of Psoriasis, but unfortunately I cannot report that I have obtained the same good results as in that complaint. Internal remedies, in particular, have always failed to produce any change in the character of Pityriasis rubra, not even relieving it in the slightest degree. Neither arsenic, tincture of cantharides, sulphur, antimony, decoctum lignorum, sarsaparilla, iodine, nor mercury, has succeeded in putting a stop to the disease.

"On the other hand, it has, to a certain extent, been modified by the repeated employment of tepid baths (in which I have kept the patient for several hours at a time), and by the application of oils and emollient ointments. Even then, however, the effect of the treatment has merely been to render the masses of epidermis more transparent, and the skin itself more supple" (97, Syd. Ed. 2: 73).

Hans Hebra reports (175, 3: 516) the treatment employed by him in a case of this disease. The duration of treatment was three years, at the end of which time the patient died, having taken in the interval 4,000

Asiatic pills, each containing 1/10 of a grain of Arsenic Comment is unnecessary.