PINTA 



2097 



fall out. The shedding of hair is not due to the fungi invading 

 directly the hair; it is due to a peculiar fibrosis of the hair follicle, 

 at the place of the hair a hard formation remaining, like a grain of 

 sand (fibroid folliculitis of Montoya). 



Pruritus is generally well marked, especially at night-time. There 

 are often patches of hyperkeratosis on the palms and soles, and the 

 normal lines and sulci appear much deeper. 



Old chronic cases occasionally exhale a peculiar musty odour, 

 which has been compared to the smell of cat's urine, or to the bad 

 smell of dirty linen kept in a warm, damp place. 



The affection may spread to the whole body, except the palms 

 of the hands and the soles of the feet. The nails are never attacked. 

 The scalp is not usually affected. 



The disease has no tendency to spontaneous cure. Its course is 

 very chronic, and may last the whole of the patient's life. 



Some of the older authors state that the patients during the incubation 

 period suffer from fever, vomiting, and diarrhoea. Montoya says that pinta 

 patients have not got an odour sui generis, as stated by most observers. In 

 cleanly patients no smell whatever is noticeable, apart from the peculiar 

 odour of the negro race. 



Clinical Varieties.— Clinically, six different varieties may be dis- 

 tinguished, each of which shows several subvarieties : — 



.1. The Black Variety. 



2. The Blue Variety. 



3. The Violet Variety. 



4. The Red Variety. 



5. The Yellow Variety. 



6. The White Variety. 



Black Variety. — The patches are of a black colour, and arc very 

 often found on the face, though they may be present on any other 

 part of the body except the palms and soles, similarly to all the 

 other varieties. The patches are hardly raised, and their surface 

 is slightly desquamating. Pruritus is generally complained of, but 

 is not, as a rule, so unbearable as in the other varieties. Black 

 pinta is found in negroes more frequently than in individuals of 

 Caucasian race. The course is very chronic. The treatment is 

 difficult, though not so difficult as in the other varieties. 



Black pinta shows two subvarieties — one is characterized by the 

 presence of patches of a black-violet colour; the other by patches 

 of jet-black, indian-ink black colour. The fungus found in the 

 first is an Aspergillus (species undetermined) ; in the second a M on- 

 toy ella (M. nigra). 



Blue Variety. — This is much less frequent than black pinta. The 

 patches are of a blue colour. They generally begin to appear first 

 on the dorsum of the hands, and then tend to spread over the 

 whole body — uncovered as well as covered parts. There generally 

 is intense pruritus. 



The fungus usually found in blue pinta is Aspergillus. 



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