The Superficial Mycoses L33 



Thymol I pei cent 



Boric arid 10 per cent 



Zinc oxide 20 pei cent 



Purified talc q.s. 



Its beneficial eflFect may be attributed « both to the active ingredients and 

 to the value of any powder in combating perspiration. 



10. A 10 per cent aqueous solution of silver nitrate is often effective if 

 painted daily on localized macerated, fissured or exudative skin areas. 



Manx other drugs and prescriptions might be mentioned. Most of them, 

 however, have little advantage except in providing a change, which is 

 sometimes essential when the infection is long drawn out. The use of 

 iontophoresis to introduce copper salts or other chemicals deep into the 

 skin has been advocated. Greenwood and Rockwood found the method 

 ineffective, a finding with which we concur. 



The use of soap and water is usually permissible. In most instances, the 

 patient should be encouraged to bathe. However, when an acute inflam- 

 matory condition exists, suspension of bathing, particularly with soap, may 

 be best (see the section on prophylaxis for instructions on the care of the 

 bathtub, p. 139). 



During the past few years many investigators have evaluated the action 

 of tatty acids, known to be protective against bacteria, as therapeutic anti- 

 fungal agents. Laboratory tests indicate a favorable effect, although clin- 

 ical trial is somewhat disappointing. Most of the acids in the concentration 

 advocated (5 to 15 per cent) are relatively nonirritating in ointments or 

 powders, an advantage in the treatment of a highly sensitized skin. At 

 this time, undecylenic acid appears to be somewhat more potent than pro- 

 pionic acid and others of the fatty acid series. Hopkins and co-workers 

 found undecylenic acid (5 per cent in carbowax, pH 6.8) to be the best 

 local preparation in their extensive investigation. Muskatblit confirmed 

 the lack of irritation from commercial preparations of undecylenic acid 

 and salts. He thought this agent had some use in the therapy of tinea, al- 

 though it was far from a superior fungicide. 



(2) Physical agents— There appears to be little if any advantage in the 

 use of ultraviolet radiation. If the disease is of the inflammatory type, an 

 induced reaction to ultraviolet rays may cause it to spread and to assume 

 an eczematous character. 



Roentgen rays, while not in themselves fungicidal, are frequently of 

 great help in cases of severe inflammatory involvement. They are impo- 

 tent in instances of infection due to T. purpureum, and little if any favor- 

 able effect will be obtained by directing them toward the interdigital webs. 

 When there is an exudative inflammatory change the rays may be helpful 

 either by aiding absorption of the exudate or by temporarily increasing the 



