he 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.

#Give the prognosis of sycosis.#

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.

#How is sycosis to be treated?#

Mainly, and often exclusively, by external applications.

[Illustration: Fig. 27. Sycosis.]

#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.

#Describe the external treatment.#

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 pe