CHAPTER VII 



Nondermatologic Allergic Manifesta 

 tions Due to Fungi 



THERE is reason to believe that sensitization and immunity phenomena 

 are of great importance not only in the development of the response 

 of the patient with a fungous infection (symptoms and signs) but in the 

 rate of response of the patient to most therapeutic measures. The subject 

 of secondary allergic manifestations of the skin ( dermatophy tids ) is dis- 

 cussed in Chapter IX in the sections on tinea capitis (pp. 58 ff.) and 

 dermatophy tosis (pp. 116 ff. ); moniliids are discussed in the section on 

 moniliasis (p. 150). It has been shown that specific sensitization to some 

 genera of fungi occurs after infection, and this fact may be demonstrated 

 by tests with fungus extracts. The possibility has also been considered 

 that fungi may act as sensitizers without causing an actual infection. From 

 this point of view we have investigated a number of cases of eczema of 

 the hands in which the cause was obscure. Patch tests with trichophytin 

 did not reveal any consistent sensitivity either on the affected area of skin 

 or at a site remote from the eczema. We had the same negative results when 

 we tested such patients with extracts of saprophytic air-borne fungi. From 

 a theoretical standpoint, an immediate wheal and flare response to a sus- 

 pected fungus allergin given by intracutaneous injections would speak in 

 favor of a direct relationship. 



1. ASTHMA 



There have been investigations of other allergic diseases and their pos- 

 sible cause by the spores of air-borne fungi. Cooke found that house dust 

 was a cause of asthma. The activity of the dust was diminished by heating. 

 Van Leeuwen noted that in localities where patients with asthma were 

 free of an attack there were few air-borne molds and yeasts. Cadham in 



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