Liver Spot Disease (Tines Versicolor)
( Originally Published 1927 )
Introduction.—Liver-spot disease is a parasitic disease and is but slightly contagious. Considering the enormous number of parasites and their location in the uppermost part of the skin, it is rather surprising how seldom this condition is transmitted to others. It has been repeatedly noticed that a husband, for instance, suffering from this affliction will fail to transmit this affection to his wife, al-though the most intimate contact has existed for years.
Description.—Liver-spot disease first makes its appearance in the form of small flat patches, which enlarge after a period of weeks or months. They have a definite border and are usually of irregular shape. They are of pale yellow or brown color in the white race, and in Negroes they are grayish. The scales are fine and can be made to appear by scratching the surface with the finger nail. This peculiarity of the scales is a characteristic feature of this affection. Itching is usually slight and is most apt to bother the patient during the summer months. The malady usually affects adults. It appears as a rule upon the body, particularly the chest, between the shoulder blades, and on the neck, but very seldom on the face.
Course.—Untreated, this affliction may last for months and years. It often disappears or grows less noticeable during the cold months, reappearing when the warm season arrives. It responds to treatment quickly but often returns, since as a rule, all of the parasites are not destroyed.
Suggestions for Treatment.—The affected skin surface should be thoroughly scrubbed with soap and water so as to remove the top part of the horny layer, thus exposing the parasites to the action of the germ-destroying remedy. In order to guard against return, it is advisable to thoroughly fumigate the underwear. Treatment requires the services of a skin specialist and his suggestions should be carried out for some time after supposed cure, so as to prevent recurrence.
The animal parasitic diseases of interest are "the itch" (scabies) and lousiness (pediculosis).
"The Itch" (Scabies).—Introduction.—Great wars tend to disrupt the ordinary mode of living, and the impossibility of proper hygiene and cleanliness carries its penalties. One of these is the development and spread of a skin condition known as "the itch." After each war, every country involved has had to deal with this condition and it has received many names; for instance, in the last Great War it was nicknamed "French itch."
Description.—"The itch" is caused by an animal parasite which is deposited on the skin surface. The male member takes no part in attacking the human skin but the female digs into the depths, and its point of entrance is marked either by a solid elevation or by one containing a clear fluid or pus.
Once having penetrated the horny cells, the female parasite digs downward in an oblique direction and forms a ditchlike path, along the course of which its eggs and fecal matter are deposited. This digging continues until the true skin is reached and then the parasite, having completed its task, dies.
The effort on the part of the female parasite is represented on the skin surface by what is technically known as the "burrow," a more or less straight, zigzag, or tortuous line about one-eighth to one-half of an inch in length and visible to the eye. It is of grayish or blackish color due to the deposit of dirt. This "burrow" is peculiar to and characteristic of "the itch." It is most often seen upon the wrist and on the sides of the fingers.
The itching of this disease is peculiar and characteristic, in that it is worse at night, especially when the sufferer is affected by the warmth of the bed. The itching induces scratching and the injury to the skin, plus infection by pus germs, produces various eruptions such as scratch marks, crusts, pus spots, solid elevations, and blister-like eruptions.
The itch mite, with almost human intelligence, attacks those parts of the skin where the horny layer is the thinnest. Therefore, the parts apt to show the eruption are the wrists, the webs and sides of the fingers, the armpit region, the areas about the nipple of the breasts in the female, and the inner sides of the thighs and legs. Infants are apt to have eruptions between the toes and on the face, while in grown-ups the face is never affected.
Scabies is usually a family disease, for often the history reveals a number of persons in a family afflicted. This fact is important in the recognition of this disease, particularly when the other signs are poorly marked.
Course.—Untreated, "the itch" may last many months. Persons who bathe frequently and use soap freely are less apt to suffer from severe symptons of this affliction; indeed, the distinctive features may be more or less removed. The term "Norwegian itch" has been applied to long-standing and neglected cases of this condition.
Contagiousness ant Transmissibility.—Scabies is a contagious and transmissible disease. Intimate body contact or application of finger nails harboring both the male and female parasites are most effective for its transmission. However, it also may occur through occupation of a bed used by a previously infected individual or through the wearing of gloves or other articles of clothing infected by these parasites or their eggs (ova). Brief shaking of the hand or passing personal contacts of the daytime 'are, as a rule, insufficient to transmit this disease. This condition is usually seen among the uncleanly; there are times, how-ever, when persons in all stations of life may be afflicted. The transmission of scabies from lower animals, such as the dog and cat, only occurs occasionally.
Suggestions for Prevention and Treatment.—The treatment of this condition requires the services of a physician.
Thorough sterilization of the underwear, night clothes, and bed linens is most necessary to prevent recurrences and lessen the danger of the spread to others. This is accomplished by boiling the linens, underwear, and night clothes for three hours, in a solution of bichloride and water, in the proportion of one tablet of mercury for every gallon of water.
Parasite.—The parasite of scabies is technically known as the Sarcoptes scabiei. It has an oval body of yellowish white color and has rows of small bristles, just about visible to the naked eye. The male is the smaller and usually dies after mating and the female succumbs after all its eggs have been laid. The young ones, known as the larvae, hatch out in from four to eight days, cast off their skin three times, then are prepared to attack man. Usually a week or two elapses after the deposit of the parasite before the characteristic features of the disease appear. The spread of this disease, through the maturing of the young parasites, re-quires a few weeks more, so that in two to three months the entire course of the malady may be considered complete.