TRYPANOSOMA 361 
The skin symptoms consist of roughening of the hair, which also falls 
out in places; a thickening of the epidermis, often with exfoliation, 
and in some stages of the disease, various skin eruptions. There may 
be simple erythema, and more rarely they may assume the severer 
forms, as urticaria, or in extreme cases a distinct localized ulceration 
may occur. The scrotum and penis in the male and the vulva in the 
female are often swollen, and ulcerations of the penis or vulva are 
frequent symptoms especially in dourine.” 
The geographical distribution of the trypanosomiases is shown in 
Figure 88. 
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