Eczema of other hairy parts

Axillae, pubes, etc. does not usually take on the sycosiform character, and epilation may be unnecessary.

Eczema of the genital region frequently presents itself as a chronic affection of the scrotum; and most of the cases will have existed for years before consulting the physician. The parts will usually be found red, dry, and thickened, and the seat of more or less pruritus. In long-standing cases there are usually decided infiltration and thickening of the skin. Of all forms of eczema this is the one which is the most difficult to control.

One writer disposes of the question of treatment in the following words:
"The treatment of eczema of the genital organs and anus does not differ from that of eczema in general, except in so far as we must bear in mind the predisposing causes, and endeavour to remove them if possible."


This general advice is good as far as it goes, but perhaps the most important of the predisposing local causes is the dependent position of the parts, and their constant exposure to friction, to say nothing of the natural moisture of the parts. As these causes cannot be conveniently removed, we must confine ourselves "to a partial mitigation of their effects. This can be accomplished, so far as the scrotum is concerned, by a properly-fitting and snubly-applied suspensory bandage. The bag should be applied in such a way as to keep the parts as elevated as possible, and with as much pressure as can be conveniently borne, - without, however, constricting the upper part so as to impede the venous circulation. If there is much infiltration, the first efforts should be toward its reduction. There are three principal methods by which we may seek to accomplish tnis end:  First, by a few scarifications of the scroturn, permitting the parts to bleed freely, care being taken not to cut any of the larger veins. After scarification the patient should sit for some minutes in a warm antiseptic sitz-bath to encourage bleeding and exudation. After the parts are dried, a little tincture of benzoin or other antiseptic lotion may be sprayed over them, and the suspensory applied. In a week or two the scarifications may be repeated. The relief aiforded by this is sometimes surprising. Many patients, however, have such a dread of cutting operations about the genitals that some other procedure must generally be advised. The second means that we have is galvanization. The constant current, applied daily or on alternate days, will sometimes reduce the infiltration and relieve the itching. The testicles should be pushed well up, and the scrotum held between two good-sized sponge-covered electrodes, and a current of eight or ten cells passed for five to ten minutes, the strength and duration of the current being regulated according to the susceptibility of the patient. The third method of reducing the infiltration is the one most commonly employed, and consists in the application of liquor potassae. This should be mopped on with a small tuft of absorbent cotton wrapped around the end of a stick. This application should be made by the surgeon himself, and not entrusted to the patient. After its immediate effects have passed off the parts may be dressed with zinc ointment and the suspensory adjusted. From six to a dozen applications, made at intervals of four or five days, will frequently produce very marked reduc­tion of the infiltration. Eczema of the penis, however, may exist alone, and if met with in persons passed middle life, and especially if the glans and inner surface of the pre­puce is involved, the presence or absence of glycosuria should be ascertained. If this condition is present, the parts should be carefully washed  after urination if the urinecomes in contact with them and an antiseptic lotion or powder applied. The general treatment should be that which is appropriate to the diabetic condition.