Kraurosis Vulv^e. Orthmann (Zeitschri/t fur Oeburtahulfe und Gynakologie, Band xix., Heft 2) reports five cases of this peculiar form of atrophy of the pudenda, which was first described by Breisky, in a paper based upon an analysis of twelve cases. The latter describes the condition as an atrophy of the skin covering the external genitals, in consequence of which even the introduc¬ tion of the finger into the vagina causes fissures in the soft parts. The introitus may become so narrowed as to interfere with coitus and parturition. Microscopical examination of sections of the affected skin show that there are retrograde changes in the upper layers of the corium, causing sclerosis of the papillae, the rete being so thin in many places that the horny epidermis rests directly upon the papillae. Sweat and sebaceous glands are absent. Regarding the etiology of this peculiar affection, nothing is known. Treatment is useless. Fleischmann later reported eight cases, confirming Breisky's observations, and Janovsky six, the latter believing that long¬ standing blennorrhoea was a prominent etiological factor. Orthmann's careful studies led him to the same conclusion as Breisky, that the cause of this affection is unknown. In his cases there was excessive itching and burning, while in those of other observers this symptom was rarely present. All the cases presented the characteristic appearances described by Breisky-smoothness, dryness and cicatrization of the skin, atrophy of the labia, and stenosis of the introitus. With regard to the treatment, after employing baths, lotions, and ointments in vain, Martin (who treated the patients in his private hospital) excised the diseased parts in toto, obtaining good union ot the extensive wounds and complete relief of the distressing irritation, of which there had been no recurrence. Cases were reported by Schroder and Kustner, in which obstinate pruritus vulva: was similarly treated with good results, but kraurosis has never before been treated surgically. PEDIATRICS. UNDER THE CHARGE OF
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