Treatment

If, as asserted by Hebra. pityriasis rubra is always and necessarily fatal, treatment other than palliative is out of the question.

In. Devergie's affection, however, every effort should be made to cut short its progress, and benefit may be expected from baths, emollients, and therapeutics.

Soothing local applications, such as bran baths or a decoction of walnut leaves followed by oily inunctions, and later by oil of white birch, are important aids. Lotions with corrosive sublimate 1-1000, or with hydrate of chloral 1-50 or 1-100, constitute an excellent application in pityriasis capitis. Sulphurated pomades have been advised; flowers of sulphur 1-30 or 1-60. For pityriasis of the face a pomade of calomel 1-100 is often efficient. Arsenicum album is the principal internal remedy used by both schools. It produces pityriasis by its physiological action; its well-known characteristics indicate its use; feverishness, with restlessness and thirst, for small quantities, etc.

Natrum arsenicum. - This drug corresponds very closely to the leading peculiarities of this disease, and I have prescribed it successfully in several cases. Its skin symptoms read: "Squamous eruption, scales thin, white, and when removed leave the skin slightly reddened. If scales remain they cause itching, worse when warm from exercise."

Arsen. iod. and Kali ars. are preparations that may be occasionally useful. I have had no trustworthy experience with either.

Other remedies may be indicated as follows:
Antim. crud. - Brownish-red spots, like small hepatic spots, here and there.

Cantharis. - Itching, followed by burning, when scratching; tendency to formation of blisters; most suitable when the disease appears in children.

Cocculus. - Red, irregularly shaped spots on the skin, over the whole chest, and on the sides of the neck behind the ears, without heat or itching, intolerance of both cold and warm air.

Conium. - Frequently recurring red, somewhat itching, spots on the body.


Graphites. - Pityriasis capitis, dryness of the skin, with cracking; localization of the eruption;  tendency to  cold from draughts of air; pains from changes of the weather; abundant desquamation from the hairy scalp.

Kreosotum. - Uneasiness during rest, with irritation throughout the body; child cannot sleep unless carried or fondled; scaly ulceration on face, elbows, wrists and fingers.

Lachesis. - Small reddish spots on face, neck and chest, which increase in numbers, become scurfy, and then disappear.

Ledum. - Aching, bruised feeling in the whole body; warm sweat of the hands and feet; bluish spots on the body like petechiae; eruption itching, with anxiety; coldness in affected parts.

Mszereum. - Chronic pityriasis capitis, loss of hair and great itching, brownish miliary rash on the chest, arms and thighs; phlegmatic temperament, with light hair.

Phosphorus. - Brown, bluish-red, or yellow blotches on abdomen and chest.

Septa. - Brown-red hepatic spots on the skin.

Sulphur is advised by the two schools. Its pathogenesis contains the formation of furfur.

Tartar emet. - Eruption dependent upon gastric derangement, nausea and vomiting, with thick white coating on tongue.