Page:Skin Diseases of Children.djvu/73

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ECZEMA.
47

desquamation in eczema is always slight as compared with psoriasis, and the margin of the scaly patch usually shades off gradually into the surrounding healthy skin, instead of being circumscribed and abrupt as is always the case in the latter disease.

In the eczema of infancy, which is a very common and often a very obstinate affection, the face and scalp are usually affected, and frequently portions of the trunk and extremities suffer to a less degree. The characteristic tendency of the eruption to assume the moist form usually manifests itself, and the face appears either inflamed and angry or covered by dried exudation in the form of yellowish or blackish crusts. The little patient often suffers intensely from the oft-recurring pruritus, rolling his head in vain attempts to alleviate it by rubbing the inflamed skin against his clothing, or, if old enough to use his hands, tearing the face and causing it to bleed by sudden, fierce, and unexpected dabs with his sharp finger nails.

The cause of eczema might be discussed at great length and still little light thrown upon the subject, for it is certainly an obscure one. It may suffice to assert that improper food and imperfect digestion are the most frequent causes of the affection as it is met with in infancy.

Infantile eczema has usually nothing to do with the teeth. It often appears before teething begins, and a similar eruption may occur in old age when all the teeth are gone. Furthermore, it is always amenable to proper treatment, whether the child has one or twenty teeth. When the process of cutting teeth interferes with the general health of an infant, it is possible for the eruption to be indirectly aggravated by the condition of the gums, but in no case is "teething" ever to be regarded as the sole cause of eczema.

The "coming-out" of eczema is never a source of thankfulness, unless it happens to come out on some other baby than our own. We might be thankful if it were to come out in the baby's clothing, and it is about as likely to do this as it is to affect any of the internal organs. Eczema is essentially a disease of the skin, and cannot be transferred to the brain or lungs any more than the ruddy glow of a healthy cheek can be "driven in." It is true that sometimes an ointment is applied to an eczematous scalp or face, the eruption quickly disappears, and shortly after the baby may die of brain or lung disease. This may appear at first thought as though the eruption had been driven in, but the facts admit of a more reasonable