TINEA UNGUIUM TROPIC A LIS 



2059 



TINEA UNGUIUM TROPICALIS. 

 Synonym. — Onychomycosis tropicalis. 



Cases of tinea unguium, or onychomycosis, occur in the tropics, 

 and are generally due to the same fungi producing dhobie itch, 

 both Epidermophytons and Trichophytons. The nails of the fingers 

 as well as of the toes may be affected. Tinea unguium may be 

 caused also by fungi of the genus Endodermophyton, the nails being 

 often affected in tinea imbricata. 



Symptomatology. — The affected nails have often a pecuhar 

 yellowish opaque or blackish discoloration, and a rough surface; 

 they become brittle, and splitting and chipping of the free border 

 takes place. 



The diagnosis is principally based on the microscopical ex- 

 amination of scrapings. A soaking in liq. potassse (40 per cent.) 

 for twenty-four hours is often necessary to disintegrate the nail 

 substance and to find the fungi. 



Treatment. — This is most difficult. The affected nails must be 

 softened by rubbing in liquor potassse, and then wet dressings of 

 hyposulphite of soda (25 per cent.), or a solution of potassium iodide 

 grms. X., iodine grm, i., water 1,000 c.c, must be regularly applied, 

 in the onychomycosis found in cases suffering, or having suffered, 

 from tinea imbricata, the daily application of resorcin in tincture of 

 benzoin (3i. to §i.) is useful. 



TINEA IMBRICATA (TOKELAU). 



Definition. — The term ' tinea imbricata ' is used to denote a 

 tropical dermatomycosis, or, more correctly, a group of dermato- 

 mycoses, due to fungi of the genus Endodermophyton Castellani, and 

 clinically characterized by the presence of extensive, flaky, scaly 

 patches, the scales being large, tissue-paper-like, firmly adherent 

 by their bases, and arranged in concentric rings or parallel lines. 



Synonyms. — As is the case with several other tropical diseases, 

 such as framboesia and Oriental sore, there is a very large number 

 of synonyms, which may be classified as follows: — 



[a) From the name of the centres where the disease is rife; for 

 instance, the term ' Tokelau,' generally used by French writers, is in 

 reality the name of an island, Tokelau, where the malady is very 

 common. Other synonyms are ' Tokelau ringworm,' used by 

 Tilbury Fox, ' Bowditch ringworm,' the name Bowditch being used 

 by some writers to indicate the island of Tokelau, ' South-west 

 Gune,' the term * gune ' meaning skin. 



[h) From the name of the patient who first introduced the disease 

 in certain countries. In the island of Tokelau, for instance, the 

 disease used to be known as ' Le Pita,' from * Peter,' the name of 

 the native of Tamana, one of the Gilbert Islands, who, according I0 

 Turner, in 1850 introduced the disease into Tokelau. 



