Editor Ellingwood's Therapeutist:
I have a patient with a very peculiar trouble for which I am unable to find a remedy. He has been to many physicians without any relief, and therefore I am asking help for him. If any one can assist me in relieving him I will appreciate it.
It looks like a true case of sunburn of the entire face, and only comes in warm or hot weather when he is out in the sun.
When he shaves smooth the entire face is affected when in the sun, but if he lets his beard grow enough to protect the skin, it only bothers the bare surfaces. It is of a very intense fiery red, with some swelling, and of a burning nature.
He can work in a foundry, or any very hot place in the building, and is not affected at all, or is not troubled in cold weather, but the first day out in the hot sun brings it on in a severe form. Then if he stays out of the sun for about four or five days it will peel off, and get well, but will not improve as long as he works in the sun. It appears on the face, neck, and ears. Who can give me suggestions for relief?
Who can give a specific for pin worms?
F. M. SHIRK, M. D.
COMMENT: I would take this case to be more than ordinary sunburn, probably, because of a peculiar sensitiveness of the skin. Ordinary sunburn—erythema caloricum—is usually followed by a discoloration of the skin, or by an increased pigmentation of the surface, and is seldom sufficient to produce swelling. This is, I think, a case of solar dermatitis of an acute character, and should be treated as such. The treatment would be much the same as that for a mild burn. There is probably here an unusual degree of nerve sensitiveness, which causes the terminal nerve filaments to be easily affected by some peculiar element in the sun's ray. It will probably be difficult to treat the skin so that this condition would not occur. Tonic astringent washes should be beneficial.