Disseminated Sclerosis in S. Africa
Authors: G. Dean
Journal: BMJ (1949)

Group 8: Chronic Papular and Fissuring Eczema.-These were 7 chronic cases of endogenous eczema.One showed some improvement, the remainder no change.Group 9: Impetigo.-Fivecases cleared satisfactorily with vioform cream.Group 10: Infantile Eczenta.-Theresults of the treat- ment of this condition were unsatisfactory.Eight cases improved equally on the cream and on the cream base, 5 showed no change, and 3 displayed some irritation on the vioform cream.Group 11: Nuiinmular Eczema.-Fourshowed marked- improvement; two appeared to be irritated by the vioform and one by the cream base.Groutp 12: Neuroderrmatitis.-Oneshowed improvement, three showed equal improvement on both preparations, whilst in one patient the base proved the more effective.Grouip 13: Lichen Hypertrophicus.-Inthree patients no change was noted.Group 14: Psoriasis.-Intwo patients with classical psOi'asis no improvement could be attributed to the vio- form.It psoriasis involving the flexures (seborrhoeic) two appeared to be improved, and four showed no change which could be attributed to the vioform.Two patients with pustular psoriasis found the active preparation and the vehicle equally effective.Grouip 15: Dermatitis Herpeliformis.-Lesions in two patients with this disord'er responded equally to the vio- form cream and base, one patient was aggravated by both, and one appeared to be aggravated by the vioform cream.In view of the sensitivity of these patients to potassium iodide locally, this measure was tried at first very carefully, but the action expected from an iodide preparation was not noted.CommentsUnfortunately, vioform is yellow and it stains.When dispensed in a water-miscible base the staining tendency is less marked.It darkens on exposure to air; this does not seem to interfere with its therapeutic efficiency.A few patients stated that on application they experienced a mild burning sensation, which quickly disappeared; when there was intolerance this symptom was more pronounced.Vioform proved antipruritic in eczematous conditions and soothing in the treatment of contact dermatitis; it showed a marked antiseptic action in pyodermia and secondarily infected dermatoses.In the media used it was found to be well tolerated. ConclusionsThe effect of 3% vioform in a water-miscible base or in petroleum jelly has been assessed under carefully.controlledconditions on a variety of dermatoses in 176 patients.It proved a useful local application in the treatment of the following conditions: coccogenic sycosis barbae, sebor- rhoeic dermatitis, otitis externa, acute vesiculo-papular eczema, gravitational eczema, impetigo, and, occasionally, in nummular eczema.The incidence of cases of intolerance was low (4.5%).This investigation suggests that vioform merits more extensive use in these conditions.cases are summarized'in Table II.Five of these patients were indigenous white South Africans, 14 were immigrants, and in the three others the diagnosis was in my opinion definitely DISSEMINATED SCLEROSIS IN SOUTH AFRIC, A BRffLSH 843 MEDICAL JOURNAL mistaken.These last three cases will not be considered further.Of the five indigenous patients, the diagnosis is considered to be correct in three and doubtful in two.Case Sex Age Race C.2 C.3 C.4 C.6 F.reflexes and slurring of speech.In'view of the fact that his sister had disseminated sclerosis this may have been a " forme fruste" of the disease.Durban.-Dr.J. Drummond, medical specialist, has informed me that he treated a case of disseminated sclerosis in a South- African-born girl who had not been abroad.Unfortunately the records have been lost, and she has long been dead.