f the skin. There are several varieties: that called
Addison's disease, that due to uterine disease, etc. In this affection
the skin assumes a dark and even black hue.

Leukoderma is a pathologic process, the result of which is a deficiency
in the normal pigmentation of the skin, and possibly its appendages.
Its synonyms are leukopathia, vitiligo, achroma, leukasmus, and
chloasma album. In India the disease is called sufaid-korh, meaning
white leprosy. It has numerous colloquial appellations, such as chumba
or phoolyree (Hindoo), buras (Urdu), cabbore (Singalese), kuttam
(Taneil), dhabul (Bengal). It differs from albinism in being an
acquired deficiency of pigment, not universal and not affecting the
eye. Albinism is congenital, and the hair and eyes are affected as well
as the skin.

The disease is of universal distribution, but is naturally more
noticeable in the dark-skinned races. It is much more common in this
country among the negroes than is generally supposed.

The "leopard-boy of Africa," so extensively advertised by dime museums
over the country, was a well-defined case of leukoderma in a young
mulatto, a fitting parallel for the case of ichthyosis styled the
"alligator-boy."

Figure 293 represents a family of three children, all the subjects of
leukoderma. Leukoderma is more common among females. It is rarely seen
in children, being particularly a disease of middle age. Bissell
reports a case in an Indian ninety years of age, subsequent to an
attack of rheumatism thirty years previous. It is of varying duration,
nearly every case giving a different length of time. It may be
associated with most any disease, and is directly attributable to none.
In a number of cases collected rheumatism has been a marked feature. It
has been noticed following typhoid fever and pregnancy.

In white persons there are spots or blotches of pale, lustreless
appearance either irregular or symmetric, scattered over the body. In
the negro and other dark-skinned races a mottled appearance is seen. If
the process goes to completion, the whole surface changes to white. The
hair, though rarely affected, may present a mottled appearance. There
seems to be no constitutional disturbances, no radical change in the
skin, no pain--in fact, no disturbance worthy of note. The eye is not
affected; but in a negro the sclerotic generally appears muddy.

It appears first in small spots, either on the lips, nose, eyelids,
soles, palms, or fo