Synonym. Freckles.
Ephelides are
yellowish, brownish, or black pigmented spots which occur on the skin as a
result of exposure to light. They are usually produced by sunlight, being worse
in the hot months, but may follow exposure to ultraviolet light from artificial
sources or exposure to x-rays. The lesions may be sparsely scattered, or
profuse. The condition is more common in blonds than in brunets; but mulattoes
are especially subject to the disorder. Freckles are usually 1 to several
millimeters in diameter and are arranged symmetrically, as a rule on exposed
portions of the skin. Some grouping may be discerned; and larger spots may form
due to coalescence. Although the face, neck, shoulders, and dorsa of the hands
are the usual locations of freckles, unexposed areas may occasionally be
affected. Freckles do not often make their appearance before the sixth or
eighth year, and from then on persist throughout life, being exaggerated each
summer. Coglievina has shown a coincidence between the location of the freckles
and of the points representing the thermic sense in the skin. The freckles may
be a biologic defensive process to protect the nerve terminal, at a
particularly vulnerable point, by an extra pigmentation. Ephelides must be
differentiated from lentigines, which are freckle-like nevi. Ordinary freckles
develop at a later age, are lighter in color, usually most marked on exposed
surfaces and are definitely related to exposure to sunlight, largely
disappearing in the winter.
The preventive treatment is similar to
that of sunburn. Freckles may be peeled off by painting lightly with phenol,
followed immediately by alcohol. Great care must be exercised in doing this.
Blonds are better subjects than brunets. Only a few freckles should be treated
at one sitting. Absorption of phenol may cause dizziness and nephritis. A
cream containing 20 per cent monobenzyl ether of hydroquinone (Benoquin
ointment) may be temporarily effective. Other lotions and creams are of little
benefit.
R
Camphor . . . . . . . . . . . . .
. . . 1.0
Salicylic acid . . . . . . . . . . . . . . 2.0
Mercury bichloride . . . . . . . . 0.06
Alcohol
. . . . . . . . . . . . .q.s. ad 50.0
M. and
S. Apply to freckles t.i.d., and when peeling begins, stop applying for a few
days; then repeat.
R Bismuth oxychloride . . . . . . . . 8.0
Ammoniated mercury . . . . . . . 2.0
Ol. Lemon . . . . . . . . . . . . . . . . . 0.12
Cold cream . . . . . . . . . . .q.s.
ad 30.0
M.
and S. Bleaching cream.