20Q0 



TROPICA L DERM A TOM YCO SES 



chlamydospores arranged in small strings, as found in certain fungi of the 

 genus Fusarium. These small chains of chlamydospores are very frequently 

 terminal, the dimensions being variable — 8-10 microns ' (Fig. 595, p. 1113)- 



In cultures on carrot and potato the colonies are white, on glucose 

 agar often amber colour. Very old cultures may show a certain 

 amount of pigmentation (see p. 1112). 



Histopathology. — The histopathological investigation of the con- 

 dition is far from completed. From the preliminary investigation it 

 would seem that the lesions are very similar to those one sees in 

 sporotrichosis, and that three types of lesions may be distinguished: 



(1) An epithelioid or tuberculoid type, with presence of giant cells; 



(2) a lympho-connective tissue type (syphiloid) ; (3) polymorphonu- 

 clear type (ecthymatous). 



Clinical Symptoms. — In a well-marked case ulcerative lesions are 

 present all over the body, though they are in smaller number or 

 absent altogether on the face, scalp, palms, and soles. Most of the 

 ulcers are sharply defined, roundish or oval, with red granulating 

 fundus. Their appearance is well shown in the illustration, a 

 photograph of a Ceylon case. In many cases there is abundant 

 purulent secretion, which collects and dries up in thick yellow crusts, 



Figs. 837 and 838. — Acladium castellanii Pinoy: Hanging-Drop 



Culture. 



{a) After twenty-four hours', (6) after three days' growth. 



covering the ulcers. Gummata-like nodules and furuncle-like 

 lesions may be observed. The superficial lymphatic glands may be 

 enlarged. The lesions in most cases give very little pain, or none 

 at all ; itching is often completely absent, but occasionally the patient 

 complains of slight pruritus. The general condition of the patient 

 is not seriously affected for a long time, but he often complains of a 

 certain degree of weakness and discomfort. Not infrequently there 

 is serotine fever. The blood has been examined in two cases in the 

 tropics; in one case in the Balcanic Zone: Wassermann reaction 

 negative. In the first two cases red blood-corpuscles and haemo- 

 globin were slightly below the normal; in one there was eosinophiha 

 (5 per cent.), which may have been due to a concomitant Ascaris 

 lumbricotdes infection. In the Macedonian case, the blood of which 

 was examined, there was a distinct leucocytosis (16,000 leucocytes) 



