Text Appearing Before Image: extendto the anus. There is usually a fairly well-marked line of demarcation betweenthe diseased and healthy skin. The etiology of kraurosis is not always clear. There is no doubt that it isusually the result of a long-continued irritation caused by discharges which, bytheir chemical action, gradually alter the structure of the vulval cutis. Apruritus of the vulva from any cause soon produces a white parchment-like ap-pearance, which, if the irritating cause continues, in time develops into a per-manent change. Some, however, regard the pathologic process of kraurosis as.an inherent primary disease. This theory has not been proved. GENERAL INFLAMMATORY PROCESSES 233 Kraurosis of the vulva is related to senile atrophy, and reference should bemade to that subject. It not infrequently serves as a starting-point for cancer of the vulva. The symptoms of kraurosis consist chiefly of intolerable itching. Patientswith this disease suffer pitifully and are often driven to acts of desperation. Text Appearing After Image: Fig. 52:—Kraurosis Vui/v\e.The clitoris and labia minora have disappeared. The vulva is white and creased. The vaginais atrophied and stiff at the introitus. This was an extreme case and was inoperable on account ofthe extension of the disease into the orifices of the vagina and urethra. The treatment of advanced cases is vulvectomy, if the process has not in-volved too much vestibule and vaginal introitus. Several cures from ovarian extract have been reported, one of them by theauthor. In this condition ovarian extract theoretically works benefit by itspower to cause hyperemia of the external genitals and thus improve the circula-tion. Results seem to bear out the theory. 234 GYNECOLOGY
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