Noma in an Egyptian mummy? • 299 



Figures 7-12. Close-up of skin ulcera- 

 tions 1-1 V in specimen No. 1565: 7, 

 8. different views of ulceration 1: teeth 

 and part of mandibula exposed; y, soft 

 tissue ulceration II and IV; 10. ulcera- 

 tion II after biopsy (/, periosteum. 

 2. maxillary bone); //, ulceration III 

 with exposed maxilla; perforation due 

 to an apical tooth abscess on level of 

 first upper premolar (arrows): 12, ul- 

 ceration V with exposed right styloid 

 process on bottom of cavity farrow) 

 (I, ascended mandibular ramus). 



to a papulous initial stage) and mor- 

 phology of the lesions (Kalkoff 1981). 

 Although there can be no doubt that the 

 ancient Egyptians were affected by at 

 least skeletal tuberculosis (Sandison 

 1972; Zimmerman 1977), the skin le- 

 sions I-IV in case 1565 were not 

 caused by Mycobacterium tuberculosis 

 of human or bovine form. 



ECTHYMA 



Ecthyma simplex is a pyogenic infec- 

 tion caused by alpha-streptococcus 

 (Korting and Denk 1974:549-550) and 

 found in subtropical and tropical areas. 

 Malnutrition and poor hygiene promote 

 its occurrence. After an initial pustuiant 

 stage, deep necrotic ulcerations may 

 follow. These can be of polymorphic 

 shape; in addition to irregularly shaped 

 circular lesions, punched-out defects 

 appear. The regressive phase is charac- 

 terized by formation of scar tissue and 

 hyperpigmentation of the marginal 

 zone. Neither stage is present in the 

 case under discussion. The mono- 

 morphic size of the lesions I-IV and the 

 depth of the ulcers to the bone clearly 

 demonstrate the incompatibility of these 

 lesions" appearance with ecthyma. 



FiGURF. 13. Dental x-ray (orthopan- 

 tomography). Arrow indicates an os- 

 teolytic area, corresponding to maxil- 

 lary' tooth abscess mentioned in Figure 

 1 1 , being in close contact to ulceration 

 III. 



Zagreb Paleopathology Symp. 1988 



