2o8o 



TROPICAL DERMATOMYCOSES 



Treatment. — The disease is easily curable, except when it attacks 

 the palms of the hands, where the treatment must be more pro- 

 longed. A salicylic-alcoholic lotion (2 per cent.), followed by a 

 resorcin ointment (resorcin, 3i. ; vaseline, §i.), answers well. When 

 the patches are small, pure formalin may be used with care. 



ERYTHRASMA. 



This affection is frequently met with in the tropics, and is 

 common on the continent of Europe, though apparently rare in 

 America. 



etiology. — It is caused by a fungus discovered by Burchardt 

 in 1859 — Nocardia minutissima Burchardt. This hyphomycete is 



very delicate and slender, less than 

 T fjL in breadth; is found in the 

 superficial horny layer of the affected 

 parts. Ducrey and Reale claim to 

 have succeeded in cultivating it, but 

 their results have not. been confirmed. 

 The description of the fungus is found 

 on p. 1061. 



Symptomatology. — The eruption 

 generally affects the genito-crural and 

 axillary regions, but may occasionally 

 spread to other parts of the body. It 

 is characterized by the presence of 

 brownish-reddish patches, rounded or 

 irregularly shaped, but with well-defined 

 borders. The borders are not elevated; 

 the surface of the patches appears 

 slightly furfuraceous, and has often 

 a somewhat greasy feeling. There are 

 no subjective symptoms, except occa- 

 sionally slight itching. 



Diagnosis. — Erythrasma is easily 

 distinguished from tinea versicolor 

 and tinea flava by the reddish tinge generally present; by the 

 characteristic difference of its sites of development, and by the micro- 

 scopical examination, which will reveal the presence of Nocardia 

 minutissima Burchardt, a fungus morphologically very different 

 from Malassezia furfur Robin or M. tropica CasteUani. The 

 differential diagnosis from tinea cruris has been discussed in this 

 chapter under the heading Tinea Cruris (p. 2042). 



As first noticed by Manson, after tinea cruris has been cured, the 

 genito-crural region may in some cases present for years a peculiar 

 brownish discoloration, and be slightly furfuraceous — a condition 

 resembling erythrasma; in such cases neither Epidermophyton 

 cruris Castellani nor Nocardia minutissima Burchardt will be found. 

 Treatment. — Washing the parts with ordinary soap and warm 



Fig, 828. — Erythrasma. 



