The disease is primarily a perifolliculitis, the follicle and its sheath subsequently becoming involved in the inflammatory process.
#How would you distinguish sycosis from eczema?#
Eczema is rarely sharply limited to the bearded region, but is apt to involve other parts of the face; moreover, the lesions are usually confluent, and there is either an oozing, red crusted surface, or it is dry and scaly.
#How would you exclude tinea sycosis in the diagnosis?#
In tinea sycosis, or ringworm sycosis, the history of the case is different. The parts are distinctly lumpy and nodular; the hairs are soon involved and become dry, brittle, loose, and fall out, or they may be readily extracted. The superficial type of ringworm sycosis is readily distinguished by the ring-like character of the patches. In doubtful cases, microscopic examination of the hairs may be resorted to.
The disease is curable, but almost invariably obstinate and rebellious to treatment. The duration, extent, and character of the inflammatory process must all be considered. An expression of an opinion as to the length of time required for a cure should always be guarded.
Ulerythema sycosiforme is extremely obstinate. Folliculitis decalvans is also rebellious.
Mainly, and often exclusively, by external applications.
#Is constitutional treatment of no avail in sycosis?#
In some instances; but, as a rule, it is negative. If indicated, such remedies as tonics, alteratives, cod-liver oil and the like are to be prescribed.
Crusting, if present, is to be removed by warm embrocations. If the inflammation is of a high grade, and the parts tender and painful, soothing applications, such as bland oils, black wash and oxide-of-zinc ointment, cold cream and petrolatum, are to be used; boric-acid solution, fifteen grains to the ounce, may be advised in place of black wash.
In most cases, however, astringent and stimulating remedies are demanded from the start, such as: diachylon ointment, alone or with ten to thirty grains of calomel to the ounce; oleate of mercury, as a five- to twenty-per-cent. ointment; precipitated sulphur, one to three drachms to the ounce of benzoated lard, or lard and lanolin; a ten- to twenty-five-per-cent. ichthyol ointment; and resorcin lotion or ointment, ten to twenty per cent. strength.