24? The Philippine Journal of Science 1922 
crops. The commonest locations are the trunk, buttocks, thighs, 
arms, and face. They simulate tinea of the skin, commonly 
called “pafio blanco,” a common affection among Filipinos, but 
from which they can be easily distinguished on account of the 
rounded shape, small size, and elevated furfuraceous surface 
of the tinea lesions when these are early and discrete; also, 
scrapings from tinea lesions treated with 10 per cent caustic 
potash solution show fungi, whereas no fungi are found in the 
white patches of leprosy. They are differentiated from vitiligo 
or leucoderma because in these there is often an increase of pig- 
mentation on the border of the patches producing a sharp con- 
trast between the lesion and the surrounding skin, which is 
not noticed in leprosy. 
In the early macula alba there is no loss of hair, no change in 
the activities of the sudoriferous glands as tested by the injection 
of pilocarpine, and no change in the sensibility to touch or to 
heat or cold. The majority of the macula alba are bacteriologi- 
cally negative, but in older patches, especially those showing a 
reddish tint, Bacillus lepre may be found. 
In some of the white patches that did not show tactile anexs- 
thesia there was noticed an inability to distinguish thermal 
differences, and in patches where both tactile and thermal 
anzesthesia existed the thermal was found to be more extensive. 
The test for tactile discrimination—that is, ability to distin- 
guish whether the affected region is touched by one or by two 
points—was not systematically applied, on account of the un- 
reliability of the answers of children. 
Injections with pilocarpine nitrate and administration of hot 
tea in an effort to determine the absence of sweat in certain 
portions of the body, especially in connection with blemishes and 
white areas of the skin, were not always satisfactory; as the 
child, being covered, had the tendency to move and wipe away 
the moisture. It was noticed in connection with the white areas 
that in some cases, after injection, the white area was absolutely 
smooth and dry, whereas the skin in the immediate vicinity was 
moist; in other cases the white areas were dry, but the imme- 
diately surrounding skin was also dry and the corresponding 
area of the skin on the other side of the body was also dry. 
In other cases the white areas showed definite sweating similar 
to the surrounding skin. 
Another early objective sign also seen in the leprosy of children 
is the shiny and flushed appearance of the legs occurring coin- 
cident with, or independent of, the white patches. Also, in- 
