The Superficial Mycoses 101 



Hyperhidrosis is a common finding in patients with dermatophytosis. 

 Just how much the sweat has to do with the furtherance of the infection 

 has been the subject ol study of a number of investigators. Levin and 

 Silvers showed that fungi will grow in sweat. Peck has found that true 

 sweat has fungistatic power not possessed by insensible perspiration. The 

 latter, when present to excess, produces maceration of the skin, which 

 accordingly is more vulnerable to the invasion of fungi. The alkalinity or 

 acidity of the sweat may play a part in the predisposition toward infection. 

 The diet, the amount of sweat secreted and the amount of evaporation 

 are factors in the pH of the sweat. 



Lowering of a patients vitality during a debilitating illness may be 

 reflected in a predisposition to the disease. A quiescent interdigital in- 

 fection may become inflammatory and spread to adjacent and remote 

 cutaneous areas. 



In main instances, predisposing factors may not be manifest, and we 

 are forced to conclude that infection may often take place when normal 

 persons come in contact with pathogenic fungi. An abrasion may pro- 

 vide a portal of entry, but even that is apparently unnecessary in most cases. 



The main factor in ascertaining the etiology and consequently the 

 prophylaxis of the condition is determination of the reservoirs in order 

 that they may be eliminated. The chief foci are to be found on the feet 

 of carriers, w 7 ho are unaware of the disease or are careless in treating it. 

 That pathogenic fungi may remain viable for some time in a dry state 

 has been proved by Farley, Weidman, Mitchell and others. Weidman 

 calculates that many pathogenic fungi may survive in the dry state from 

 approximately six months to a year. Fungi of pathogenic titer have been 

 yielded by cultures of material from floors, mats and gymnasium apparatus 

 (Williams), shoes (Jamieson and McCrea), cotton, linen, silk (Hruszeck- 

 Kadisch), wool and silk and many different woods and in the presence of 

 moisture (Bonar and Drever). Goldman mentioned that spores of fungi 

 have been carried nearly 14 miles (22 kilometers) up into the stratosphere 

 and have survived cold, solar radiations and other extreme conditions. 

 Fortunately, however, the spores of fungi are not as resistant as those 

 of bacteria. Moreover, they are readily destroyed by heat. Weidman found 

 that most species of fungi in culture and in scrapings were killed by ex- 

 posure to a temperature of 48 C. for 10 minutes. 



(d) Immunologic reactions.— This topic is discussed at length in Chap- 

 ter VI, "Immunity and Cutaneous Sensitization." The practical importance 

 of the routine use of the trichophytin test in connection with other studies 

 is well recognized. Initiation of sensitivity 48 hours after the test occurs 

 in about 70 per cent of patients infected with T. gypseum, while only 30 



