The Superficial Mycoses 163 



cut countries, that it max affect different types <>l persons and that it ma) 

 be caused In a variety <>t organisms, lie did not believe that the rays of 

 the sun play any part in the cause. Further investigative work appears 

 necessary to clarify the picture. 



(3) Tinea flava or tinea versicolor tropicalis.— Castellani stated that this 

 condition is identical with achromia parasitaria (Pardo-Castello and Dom- 

 inguez). The fungus responsible cannot be distinguished from M. furfur 

 in potassium hydroxide preparations, and like that organism it is nonenl- 

 turable. Castellani differentiated tinea flava from tinea versicolor as it 

 occurs in the temperate /.ones by the following points. (1) Tinea flava 

 begins in childhood and may persist during life. (2) It usually affects the 

 exposed parts of the body. (3) Cure is difficult. (4) The fungus seems to 

 have a marked depigmentary action. 



(4) Endemic vitiligo of Turkestan.— According to Kistiakovskv, who 

 has observed the disease, there is no difference between this disorder and 

 vitiligo. 



(5) Pinta. —When this condition is observed early, the characteristic 

 hues of the affected skin in no way suggest tinea versicolor. Later, when 

 vitiliginous areas are present, differentiation may be more difficult. The 

 disease causes coarse scales, the affected skin is infiltrated, occasional 

 Assuring is noted, and loss of hair is usual. When extensively involved, the 

 skin presents an odd, piebald appearance. 



(6) Syphilitic leukoderma— This condition is seen almost exclusively in 

 women. The lesions are commonly symmetrically located on the sides and 

 back of the neck, are oval or irregularly shaped and vary from the size 

 of a split pea to that of a dime. Concomitant hyperpigmentation is some- 

 times noted. No scaling is present. Other evidence of syphilis, including a 

 positive serologic reaction, may usually be detected. 



(7) Vitiligo.— The irregular, asymmetrical, snow-white patches, show- 

 ing hyperpigmented edges and affecting by preference the face, hands, 

 forearms and male genitalia, should not often prove difficult to differentiate. 

 No scaling is present. Vitiliginous skin observed under filtered ultraviolet 

 rays has a characteristic fluorescing, glistening white appearance. It must 

 not be forgotten that patients with tinea versicolor may also have vitiligo. 

 This unrelated association is the probable explanation for the absolute 

 achromia reported by a few 7 observers and thought to be consecutive to the 

 pigmented rash of tinea versicolor. 



(8) Posteruptional depigmentations.— Seemingly depigmented areas may 

 be noted at the former sites of syphilitic, psoriatic and other cutaneous 

 lesions. Without any history of a preceding eruption, differential diagnosis 

 inav be difficult. 



