940                                            NEUROSES

DERMATALGIA

Synonyms.—Neuralgia of the skin; Rheumatism of the skin; Fr., Dermalgie; Ger.,
Nervenschmerz der Haut.

Definition.—Dermatalgia, or dermalgia, is characterized by pain
in the skin independent of any structural lesion.

The pain is usually localized; it may, however, be more or less general.
Various sensations are experienced, such as burning, stinging, pricking,
shooting pains, which are generally aggravated during the night. It
is spontaneous, and constant or intermittent in character, insignificant
or severe. Motion and the slightest contact may give rise to a
severe attack. It is seated more commonly in hairy portions of the
body, and is most frequently seen in middle-aged females. It is often
associated with hyperesthesia, more or less pronounced. It is usually
confined to the superficial layers of the skin, which present no perceptible
changes, being to all appearances normal in thickness, coloration, and
temperature.

It is a difficult matter to decide in a given case whether the pain is
idiopathic or attributable to some pathologic change in the nerve-centers.
Rheumatism would seem to act as an exciting cause in quite a number
of cases; exposure to cold, chlorosis, and hysteria are also factors. Sys­
temic disorders, as syphilis, diabetes, etc., and pathologic alterations of
the nervous system, as in locomotor ataxia, play an important rôle in
its production.

Causalgia, which is characterized by a burning pain with pain and
tenderness at various neighboring points, and accompanied with a glossy
state of the skin in the area of a nerve that has been injured, may be
regarded as an allied affection.

From neuralgia and muscular rheumatism it may be differentiated
by having its seat usually in circumscribed areas of the skin and by
being more superficial in character. In pruritus pain is absent and
itching is a prominent feature; in dermatalgia, moreover, the area in­
volved is generally limited.

Treatment.—This will be governed by the underlying cause
and whether we have to deal with a symptomatic or idiopathic variety of
dermatalgia. The general health must be carefully looked after, and
if a gouty or rheumatic history is disclosed, the appropriate remedies
should be prescribed. In chronic cases careful search must be made
for any existing disease of the nerve-centers. Local applications may be
resorted to, such as blistering the part; tincture of aconite root and
diluted tincture of belladonna or galvanism may be applied to the sensi­
tive area. As a rule, however, external remedies fail to accomplish very
much. Quite frequently, after several weeks, the pain disappears
spontaneously.

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