TINEA SABOURAUDI TROPICA LIS 



2051 



natural folds. Several horny semidetached discs can often be 

 seen at the dilated orifices of the sweat glands. The affection is 

 very chronic; it may begin in youth or in adult life. After some 

 time a process of apigmentation of the skin sets in, white patches, 

 leucoderma-like, developing, and extending often to the legs and 

 arms. 



Treatment. — Tincture of iodine and chrysarobin ointment (i to 

 5 per cent.) answer fairly well, but the apigmented patches are not 

 cured. 



TINEA SABOURAUDI TROPICALIS. 



This trichophytosis was first described by Sabouraud in patients 

 returning from Indo-China, Japan, and Tonkin. We have seen a 

 few cases in Ceylon. 



-ffitiology. — The disease is caused by the fungus Trichophyton 

 blanchardi Castellani, 1905 (synonym, T. sahouraudi Castellani, 

 1905). The term T. sabouraudi cannot be applied to this Tricho- 

 phyton, as this name has already been used for another Tricho- 

 phyton — T. sahouraudi R. Blanchard, 1905. This fungus cannot be 

 grown on Sabouraud' s media or any other media we have tried. 

 Microscopically the mycelial tubes do not show a double contour, and 

 are not very straight; they are often banana-shaped. The seg- 

 ments of the mycelium are all separated; the mycelial spores are 

 roundish, and are shed without forming a filament by their union. 

 They are of various sizes. 



Symptomatology. — The eruption generaUy commences on the 

 uncovered parts of the body, generally on the legs; the patients 

 often state that they think the disease is due to prolonged immer- 

 sion in stagnant water. The affection begins with erythematous 

 patches, the surfaces of which are covered with minute pityriasic 

 squamae. After reaching the diameter of about i or ij inches, the 

 patches become circinate. The circination, however, is incom- 

 plete; it is only segmentary. In dependent positions large poly- 

 cylic patches may be seen, but only one-half or one-third of the 

 circles are clearly seen, the rest being badly defined. The base of 

 the patches at this stage is of a very dark bistre-brown colour. 

 The border shows polymorphic lesions, fine pityriasic squamae, 

 minute vesicles and papules. The pruritus is very marked, and 

 excoriations, due to scratching, are constantly present. In chronic 

 cases a thickening of the skin, with lichenification, takes place, 

 specially at the circinate borders. 



Treatment.^ — The disease is difficult of cure in the tropics, though 

 it may disappear spontaneously on the patient proceeding to 

 Europe. Chrysarobin ointment (i to 4 per cent.) is the best 

 treatment. 



