The Superficial Mycoses 



99 



examined painstakingly In clinical, microscopic and cultural methods. 



(b) Historical survey.— According to Ormsby, ringworm ol the hands 

 was noted by Tilbury Fox in INTO and by Pellizari in 1888. The first detailed 

 study of ringworm as it affects the hands and feet was that ot Djelaleddin- 

 Monkhtar in L892, and credit should be given him for timely and accurate" 

 observations. Whitfield, Sabouraud and Kaufmann-Wolfl made early reports. 



In this country, Ormsby and Mitchell were the first to report a compre- 

 hensive series of cases of ringworm of the hands and feet. Many investiga- 

 tors have since reported their findings. A selection will be found in the bib- 

 liography. YYeidman's article (1927) was, and still is, the most important 

 published on this subject in the American literature. The literature on this 

 subject has been enriched by the exhaustive researches and careful, pains- 

 taking observations and deductions of J. Gardner Hopkins and his group. 

 The studies were carried out from 1942 to 1945 at an infantry post, Fort 

 Benning, Georgia. 



Allergic secondary lesions (dermatophytids) were described by Jadas- 

 sohn and others of his school as emanating from a deep focus such as an 

 infection of hair follicles. C. M. Williams first showed that similar lesions 

 can be present on a localized part of the body (usually the fingers and 

 palms ) when the primary focus is on the interdigital webs of the feet. This 

 observation has been substantiated by Peck, Walthard and many others. 



Hodges' report in 1921 focused attention on the disease as it affects nails. 



(c) Etiology.— Two organisms, T. gypseum and T. purpureum, cause 

 the bulk of the infections (Table 16). Whereas in civilian life, E. inguinale 



TABLE 16.— Results of Culture of Material from the Feet over a 

 Five Year Period (1942-46 Inclusive) 



is relatively uncommon as the cause, Hopkins and his co-workers reported 

 an incidence of 17 per cent in soldiers; the}' found T. gypseum in 47 per 

 cent and T. purpureum in 36 per cent of positive cultures. M. albicans may 

 also cause intertrigo of the toes, and in rare instances M. lanosum and sev- 

 eral other dermatophytes have been cultured. Occasionally lack of results 

 from culture when a condition was clinically thought to be dermatophy- 

 tosis has led some observers, including ourselves, to believe that strepto- 



