opathic
or symptomatic. Some of these cases, especially in hysterical subjects,
belong under the "feigned eruptions," being self-produced.

As an idiopathic disease, it begins as erythematous, dark-red
spots--usually preceded and accompanied by mild or grave systemic
disturbance--which gradually pass into gangrene and sloughing; the
eventual termination may be fatal, or recovery may take place. As a
symptomatic disease, it is occasionally met with in diabetes and in
grave cerebral and spinal affections.

In Raynaud's disease (symmetric gangrene) the parts affected are the
extremities, such as fingers and toes, the ears and nose, only
occasionally other parts. The first symptoms observed are coldness and
paleness of the part; followed sooner or later by congestion of a dark
red, livid, or bluish color, with sometimes swelling, and tenderness and
shooting pains. The termination is usually in gangrene of a dry
character, with, in some instances, vesicles and blebs along the edges;
in other cases the parts become atrophied, withered, and indurated.

Treatment is based upon general principles.

#Erysipelas.#

#What is erysipelas?#

Erysipelas is an acute specific inflammation of the skin and
subcutaneous tissue, commonly of the face, characterized by shining
redness, swelling, [oe]dema, heat, and a tendency in some cases to
vesicle- and bleb-formation, and accompanied by more or less febrile
disturbance.

#Describe the symptoms and course of erysipelas.#

A decided rigor or a feeling of chilliness followed by febrile action
usually ushers in the cutaneous disturbance. The skin at a certain point
or part, commonly where there is a lesion of continuity, becomes bright
red and swollen; this spreads by peripheral extension, and in the course
of several hours involves a portion or the whole region. The parts are
shining red, swollen, of an elevated temperature, and sharply defined
against the sound skin. After several days or a week, during which time
there is usually continued mild or severe febrile action, the process
begins to subside, and is followed by epidermic desquamation.

In some cases vesicles and blebs may be present; in other cases the
disease seriously involves the deeper parts, and is accompanied by grave
constitutional symptoms. In exceptional instances sloughing takes place.

A mild, transitory, limited, and often recurrent erysipelatous condition
of the outlet and i