64 An Introduction to Medical Mycology 



Tinea amiantacea (asbestos-like tinea) was first described by Alibert in 

 1832. The disease has lately been reviewed by Becker and Mnir. It should 

 probably be classed as a pseudomycosis, since no constant fungous flora is 

 demonstrated. It is important, since the clinical signs simulate those of 

 tinea capitis. It is thought by some to be a form of seborrheic eczema and 

 by others to be an aberrant form of psoriasis. The disease is manifested on 

 the scalp by a binding together of the proximal portions of the hairs by 

 asbestos-like laminated scales. It may be localized to one area or distrib- 

 uted over the entire scalp. Scaling is present on the involved surfaces, but 

 usually with little visible inflammation. The disease is said to occur most 

 frequently in children. There is no tendency to loss of hair, nor is the struc- 

 ture of the hair altered. The peculiar large yeastlike bodies which have 

 been noted are probably artefacts caused by the action of potassium 

 hydroxide on grease. The condition is usually helped by frequent washing 

 of the scalp and by the application of a salve containing sulfur or tar. 

 Recurrence is common. 



Trichorrhexis nodosa is a disease in which the hairs show one or more 

 nodular enlargements. Microscopically, these nodules are due to partial 

 transverse fracture. When the fracture is complete, the end is frayed. 

 A certain amount of thinning of the hair may result. 



Monilethrix, a congenital disease, also produces a variable degree of 

 alopecia. The affected hairs have a peculiar undulated appearance due to 

 regular variations in their diameter. Where the diameter is reduced, a 

 fracture is apt to occur. Keratosis pilaris is often associated, and general- 

 ized scaling of the scalp is common. 



In all cases of suspected infection, one is not justified in being content 

 with a clinical diagnosis. Examination of the scalp under filtered ultra- 

 violet rays and microscopic examination of material such as hair and scales 

 are mandatory- It is also highly desirable to inoculate a culture medium 

 and determine the specific diagnosis. Such procedures are simple to 

 perform and yield exact information. 



(g) Prognosis.— There is a marked difference in the prognosis with dif- 

 ferent types of ringworm of the scalp. In general, infections caused by 

 fungi which are also pathogenic to animals are quickly cured, and often 

 cure is spontaneous. The causative fungi not pathogenic to animals cause 

 infections which are resistant to treatment and which, if unchecked, re- 

 main for an indefinite period. Microspora in general are responsible for 

 benign infections; Trichophyta produce either infections rebellious to 

 treatment (endothrix ) or severe inflammations (ectothrix). The infections 

 dwe to Microspora tend to clear up spontaneously at or about the age 

 of puberty. Rotlunan and his co-workers have demonstrated that this spon- 



