Follicular Hyperaemia

Hyperaemia of the follicles of the skin is often confound­ed with diseases which it complicates, and it is important that this accident common to many dissimilar diseases and its true significance should be distinctly understood in re­lation especially to the matter of general diagnosis.

Whenever the skin is much irritated, and particularly if scratching is practiced for the relief of itching, the follicles are apt to become congested. The result is that red hyperaemic papules are formed by erection and turgescene of the upper part of the follicular walls. If the hyperaemia persists long enough a certain amount of hypertrophous growth may take place as a consequence of the hyperaemia, and solid papules may then form at the hair follicles which may from being scratched become covered at the apex with scales of dried blood that has been effused from the excoriations; in fact, the papules become pruriginous. But this is only a secondary result, not a primary condition. This accident of follicular congestion is found in a variety of diseases, and must be care­fully distinguished from primary mischief, though in itself it indicates an excessive irritation of the skin. It is, in fact, the sign of a "scratched skin," and should be always recognized as such.