The Superficial Mycoses 93 



after all vestige ol the disease has gone, until cultures inoculated with ma- 

 terial from the sites ol the former lesions are sterile. It should also be a 

 rule to examine the patient carefully for other evidences ol the disease, 

 since the body lesions are rarely the primary manifestations. In favus, the 

 scalp is usually the initial site of infection; with T. purpureum the feet, 

 groin or nails are usually concomitantly infected. In ease of a deep infec- 

 tion (Majoeehis granuloma) filtered roentgen therapy should be adminis- 

 tered, wet dressings applied and the iodides prescribed lor internal use. 

 Salves seldom help. 



We do not now use or recommend the use of ultraviolet rays or injections 

 of trichophytin in the treatment of tinea glabrosa. 



In rare instances there is a complete absence of resistance to infection on 

 the part of the patient. This may rarely occur in cases of infection with 

 fungi that ordinarily cause acute inflammatory responses in the patient's 

 skin. Hazel and Lamb recorded the case of a girl, 23, who had gastrointes- 

 tinal moniliasis and coincidentally a cutaneous rash due to M. lanosum. 

 The latter eruption was widespread on the face and body; the fingernails 

 and toenails were involved. The M. albicans infection was of 14 years' 

 duration; the manifestations of M. lanosum had been present for seven 

 years. Every possible form of therapy was administered without any con- 

 sistent effect. We have observed several instances of resistance to treatment 

 when cultural studies revealed a fungus which ordinarily responds satis- 

 factorily within a short while. Fortunately, instances of stationary infections, 

 such as that of the patient of Hazel and Lamb, are rare. 



BIBLIOGRAPHY 



Hazel, O. G., and Lamb, J. H.: Generalized skin eruption with gastrointestinal involvement 

 due to two different species of fungi, J. Oklahoma M. A. 27:395, 1934. 



Molttch, M.: Dihvdroxv-anthranol in treatment of ringworm of face, neck and arms (tinea 

 circinata), J. A. M. A. 106:1563, 1936. 



Paul, N.: Favus of glabrous skin, Brit. J. Dermat. 48:247, 1936. 



4. TINEA CRURIS 



This is a superficial fungous infection usually confined to the inner sur- 

 face of the upper parts of the thighs. There may be contiguous spreading, 

 or other parts of the skin may become affected. In India the ailment is 

 known as dhobie itch. It is sometimes still referred to as eczema mar- 

 ginatum, under which term it was first described by Hebra in I860. 



(a) Etiology.— The classic form of the disease- is caused by E. inguinale 

 (floccosum). It may be spread by infected articles of clothing or by an 

 athletic suspensory, but at times the exact method of dissemination is un- 



