Lichen Scrofulosorum

The disease occurs essentially in strumous subjects. It shows itself in the form of little elevations about the size of millet seeds, either pale, or yellowish, or a brownish red color. These papules never become vesicles; they are grouped together, sometimes in circles, sometimes in segments of circles. The papules are seated at the hair follicles, and are by and by covered by thin scales; the patches itch slightly, but not so much as to be scratched, and hence they are not excoriated.

The patches remain in one condition a long time, and undergo no changes but exfoliation and involution. The disease is limited to the trunk, the belly, the breast, and back, being rare on the extremities. Its course is very slow. Generally speaking, many groups of papules develop at the same time. They soon reach the height of development and then remain awhile in status quo. In consequence of the absence of local symptoms, the disease exists unnoticed for some time. When at its acme, other symptoms are observed; between the groups, and at the same time, on parts free from lichen - that is, on the extremities and face - more or less numerous isolated bluish-red elevations are developed, these are about the size of lentils, and look very much like common acne; some of the papules are said to contain pus; then by and by they wither and disappear, leaving dark pigmented lentil-sized marks in some places, whilst in others fresh formations take place. The skin be­tween the diseased patches is the seat of desquamation, the scales being pale and shining, whilst the whole skin may assume a cachectic appearance. In 90 per cent., the disease is observed in markedly scrofulous subjects, and particularly children, together with swelling of the sub-maxillary, cervical, and axillary glands, with caries and necrosis, or tabes mesenterica.

The treatment is the same as for scrofula. Cod-liver oil internally, with inunctions of oil externally is a great aid in treatment of these cases.