2046 



TROPICAL DERMATOMYCOSES 



or in small pools of water more or less stagnant. It is certain that 

 clothes belonging to infected persons are washed together with 

 other clothes. Dhobie itch is very contagious; true epidemics 

 occur in schools and among soldiers in barracks. 



Prognosis.—If the affection is not energetically treated, it has a 

 tendency to become very chronic and last for years. Occasionally 



the eruption spreads to the whole 

 body, forming rings or solid patches; 

 at other times a distressing der- 

 L . matitis develops on old dhobie-itch 



H|||hMw;- patches, due to scratching. Tinea 



[j^^^HB cruris may disappear during the 



^^^^Hk cold season, or when the patient 



^^^H||^%^ goes to the hills, only to reappear 



■^Hp as soon as the hot season com- 



wmlK' mences. During the period of qui- 



escence the skin of the affected 

 regions often shows a brownish dis- 

 coloration, furfuraceous, somewhat 

 similar to erythrasma. 



Diagnosis. — The diagnosis is easy 

 in recent cases, the festooned 

 appearance of the eruption, limited 

 by a sharp, elevated, bright red 

 edge, being quite typical. In old 

 cases, especially when secondary 

 lesions due to scratching are present, 

 the diagnosis may be very difficult, 

 the affection being often mistaken 

 for eczema. 



In doubtful cases the micro- 

 scopical examination will be of 

 great help. It must, however, be 

 iL noted that in old cases the fungus 



WKm "^^y be extremely scarce, the myce- 

 [Ei^;: JHh ^^^^ being practically absent, and 



only a few spores being found ; it is 

 well to take the scrapings for micro- 

 scopical examination from the edge 

 of the eruption. The differential 

 diagnosis must be made from ery- 

 thrasma, intertrigo, and eczema. 

 In erythrasma the patches have a fawnish or dark reddish colour, 

 and present often a fine pitjriasic desquamation ; the eruption is not 

 limited by a raised red edge; the fungus Nocardic minutissima 

 Burchardt is quite different from^Jthe fungi found in dhobie itch. 



Intertrigo is very common in the tropics, especially in corpulent 

 persons. The lesions are very superficial, have not a festooned 

 contour, and the margin is not sensibly elevated ; no Epidermophyton- 



Fig. 803. — Dhobie 

 THE Axillary 

 Tinea Axillaris. 



Itch of 

 Regions : 



Case due to Epidermophyton 

 cruris Castellani. 



