2082 



TROPICAL DERMATOMYCOSES 



inducing identical clinical conditions. In the tissues all the organ- 

 isms exist as yeast-hke, oval, or roundish cells. 



Among the organisms which cause the disease, Ricketts distinguished four 

 types : — 



1. Blastomycetoid or yeast-like tjrpe: reproduction by budding; in cultures 

 only oval or roundish cells are seen, while myceUal tubes are as a rule absent. 



2. Cryptococcus-like type: reproduction by endosporulation within the 

 tissues. 



3 . Endomyces-like type : the cultures present abundant submerged mycelium^ 

 which breaks up into chains of endoconidia; proliferation by budding is rare. 



4. Hyphomycetoid type: cultures present aerial hyphae and submerged 

 mycelium; proliferation by gemmation occasionally seen. There are many 

 transition forms between these four groups. 



Fig. 830. — -Blastomycosis of the Fig. 831. — Blastomycosis of 



Upper Lip: Ulcerative Stage. the Mol'th. 



(From a case in the Colombo Clinic ) (From a photograph by Splendore.) 



Histopathology. — ^There is marked proliferation of the epithelial 

 layers, with elongated, irregularly shaped down-growths into the 

 corium, and epithehal globi are seen. The cells of the rete are 

 swollen, and there is, between the cells, a polymorphonuclear leuco- 

 cytic infiltration. Here and there minute miliary abscesses are 

 present. In these, numerous polymorphonuclear and mononuclear 

 leucocytes are found, also epithelioid cells and giant cells, some 

 containing the parasite. It is in the miliary abscesses that the 

 organism is mostly found. The corium presents a general cellular 

 infiltration made up of polymorphonuclear leucocytes and young 

 CO aaective-t issue cells. The vessels are dilated and their walls 

 thickened. Splendore has noted that when the lymphatic glands 



