Ulcus Tkopicum 



BY 



The Dirkctok 



Plate XIII., fig. 2 



This is another foim of skin lesion which does not appear to be very common in the 

 Sudan. To judge by specimens received it would seem to be more frequent on the Eed Sea 

 coast than elsewhere. It need only be mentioned, as the microscopic findings are exactly 

 like those detailed and figured by Keysselitz and Mayer' in their admirable paper. The Probable 

 cause of the disease would appear, in all probability, to be the spiroch:rte described by '^^"^^"'^ 

 Prowazek under the name of S. schaudiniti. Its freqirent association with fusiform bacilli 

 is interesting. In the few cases seen in the Sudan this symbiosis has always been 

 encountered. 



Castellani and Chalmers- give an excellent account of the condition, and I note they 

 say that it is particularly common in certain islands of the Eed Sea. 



Leucodeema 



BY 



The Directok 



In our First Keview Sujiplement attention was directed to this condition in the 

 Tropics. Eecently, a paper by Sir Jonathan Hutchinson'' appeared in which he discusses 

 the subject fully and which has led the Editor of the Indian Medical Gazette to ask 

 for information regarding its prevalence amongst Indians. It is said to be spreading 

 amongst the Parsees. 



The disease occurs in the Sudan and appears to be associated with syphilis. 

 Figs. 59-61 are photographs of a case in a syphilitic Sudanese soldiei- from the Lado 

 District, Upper White Nile. 



In addition to the white patches there was a serpiginous, scaly eruption the spreading Sei-piginuus, 

 edges of which looked as though coated with hoar-frost. These distinguished the condition ^'^^'^ eruption 

 from Pinta, as did the absence of any fungus in samples of the scales examined by 

 Captain Archibald. A few cases of Pinta have been recorded from Egypt so it is 

 necessary not to confound the two conditions. The photographs were taken by 

 Mr. Buchanan with the kind permission of Captain Burney, E..\.M.C., who had charge 

 of the case. Some leucoderma cases might also have to be distinguished from anaesthetic 

 leprosy. The etiology of true tropical leucoderma is apparently quite unknown, Init it is 

 regarded as a trophoneurosis. In this case, of course, the syphilis may only be an 

 accompanying condition, but the association of the two skin lesions is suggestive. 



' Keysselitz, G., and Mayer, M. (1009), " Ulier das Ulcus tropiciim." Archtv. fiir ScJdff:- and Trnpcn- 

 Hygienf.. 



'' Castellani, A., and Chalmers, A. .1. (191U), Maiuml nf TnypU-ul Maliciiii; London, jiji. 1118-1122. 



■' Hutchinson, J. (September 1910), "Leucoderma in Dark Baces." — Poltjclink, <\\\oted. in Indian ilalical 

 Gazette, December, 1910. 



