2058 



TROPICAL DERMATOMYCOSES 



Diagnosis. — This is based on the clinical characters mentioned, 

 and on the microscopical examination of the hairs and squamae 

 in liquor potassa?. Cultural methods should also be used. 



Prognosis. — This is rather bad in the common variety found in 

 Ceylon, due to T. violaceum var. decalvans, as the patches in most 

 cases remain permanently bald, though fortunately they are, as 

 a rule, of small dimensions. The treatment of every type of tinea 

 capitis is long unless X rays are used. 



Treatment. — The Rontgen rays treatment, using Sabouraud's 

 method, is by far the best and quickest. Details on the technique 

 will be found in any up-to-date book on dermatology. In many 

 tropical places this treatment is out of the question, and epilation 

 and application of turpentine oil, tincture of iodine, or — ^with care— 

 a chrysarobin ointment (2 to 5 per cent.) must be resorted to., 



Garrett recommends the application of liquor ferri perchloridi fort. (B.P.) 



after thorough cleaning of the patches with benzene. Sabouraud at one 

 time recommended the internal administration of taUium acetate. Cicero 

 uses a 5 per cent, solution, giving as many drops as is represented by twice 

 the number of kilogrammes of the child's weight. 



TINEA BARB^ TROPICALIS. 



The same remarks can be made on this subject as on tinea capitis. 

 Cases are found in the tropics, though apparently less frequently 

 than in temperate zones, and the fungi have so far been very little 

 investigated. In Northern Africa a fungus commonly found is 

 Trichophyton violaceum Bodin; in Ceylon T. nodoformans Castellani 

 is often found. 



Symptomatology. — The dry variety, with scaly, often gyrated 

 lesions, and the pustular variety, with purulent folliculitis, can be 

 distinguished. ' 



We have seen a typical case of kerion barbae due to T. nodo- 

 formans in a person who was suffering from tinea cruris due to the 

 same fungus. 



Diagnosis. — The diagnosis, in the pustular type, is based on the 

 spreading folliculitis with brawny swelling and the microscopical 

 examination of the hair ; in the scaly type, on the frequent gyrate 

 type of the eruption and the microscopical examination of the 

 scales and hair. 



Prognosis. — The disease takes a long time to get well, even under 

 appropriate treatment. 



Treatment. — ^This consists in epilation of the affected region, 

 each day clearing a square inch or so, followed by the application 

 of some antiseptic ointment such as Crocker's ointment of sulphur, 

 3ss.-3i.; ac. carbol., 3ss. ; lanolin c oleo, §i. ; or oleate of copper, 

 3ss. to §i. 



Tinea Giliorum. 



We have seen a case of this affection in a man suffering from" generalized 

 dhobie itch, due to T. nodoformans. The lid was swollen and red, many 

 cilia were broken, and there was purulent inflammation of the hair follicles. 



