DERMATITIS EXFOLIATIVA NEONATORUM (RITTER'S DISEASE)

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Abstract
In 1878, Ritter,1 of Prague, reported 297 cases of an acute noncontagious disease of infants which was characterized by a rapidly developing erythema, dermatitis and exfoliation with a lack of general manifestations, and accounting for a mortality approaching 50 per cent. The condition had been endemic in a foundling asylum under his supervision during the foregoing ten years. In 1868 and 1870, he had described cases, but under the title of dermatitis erysipelatosa. The onset of the condition was usually between the end of the first and the fifth week of extra-uterine life. The most frequently noted early symptom was air erythema about the mouth which rapidly spread over the entire body. Exfoliation of the outer layers of the epidermis occurred, exposing red glazed patches of the mucous layer, the appearance being similar to that following a scald. Fissures at the angles of the mouth were common, and grayish exudate covered patches were frequently seen on the mucous membranes of the mouth. Vesicles or bullae were infrequently seen and when they were present they were flaccid, occurring usually as part of an atypical onset and later giving way to the usual picture. In most cases, the epidermis could be rubbed off on involved areas. General symptoms were characteristically absent, and the infant, although looking miserable, fed normally and did not lose weight. The condition lasted from seven to ten days, the regeneration of epithelium occurring rapidly in favorable cases. Pneumonia, erysipelas, furuncles, eczema and gangrene were not infrequent complications. Death occurred as the result of exhaustion or complications.

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