H. S. Stannus 
355 
the electrical reactions of the affected limbs are normal and there is no evidence 
of disease of the nervous, blood or excretory systems. 
As far as I am aware no mention has been made of the disease occurring 
elsewhere than among West African negroes, I therefore give some details of a few 
cases met with by myself. 
Ghisfufu. Male, aged about 36. The headman of a village near Zomba. 
Subject states that the disease commenced on the left side of the chest when be 
was 6 years of age, then both hands and arms were affected followed immediately 
by the legs, and it has been slowly progressive till the present time. When seen 
there was a spotty hyperpigmentation on the front of the chest (see Plate XX, 
Fig. 29) only two areas being actually of a pink hue, the same condition is seen 
on the back ; the changes on the hands and feet are typical. The depigmen- 
tation seems to have occurred in circular areas so that on fusion the margin 
assumes a scalloped form. 
X. Female, aged 50. States that her affection only commenced 2 years ago. 
On examination the left hand and wrist are found to present the typical features 
of the disease, and though of only 2 years' duration it is as marked as in cases of 
20 years' standing. On the palm of the right hand there are some spots |" in 
diameter of slight hyperpigmentation, signs of the commencement of the disease 
in this extremity. 
Binti Masua. Female, aged 30, of Mpouda, wife of Mwini Dowa, private 
1st King's African Rifles. 
She states that she had yaws when aged 8 and that the leucoderma 
appeared at that time, and has remained of about the same extent since childhood. 
On examination there are seen some black areas on the arms, apparently the 
hyperpiginented scars of old yaws. She has a Dupuytren's contracture affecting 
botli little fingers, the first interphalangeal joints of both hands are thickened, and 
the fingers show a slight degree of ulnar deflection. The affection is less advanced 
in the left hand than the right. In the former the depigmentation only affects 
the palm, while on the right side, the dorsum and fingers are also involved. 
Hyperpigmentation is present as a band round the wrist, along either border of 
each hand across the bases of the phalanges and on the back of the first fingers 
and sides of the middle fingers. 
Licheta. Male, aged 50, inmate of the Central Prison, Zornba, an Angoni of 
Dedza. 
The disease is said to have commenced at the age of 17 on the palmar surfaces 
of the wrists, since when it has very slowly spread till the present time. 
The affected areas include both surfaces of the hands and wrists, and extends 
two inches on to the forearm ; the depigmentation is patchy in character ; where 
the process has been most intense the skin is of a yellowish pink colour. Circular 
areas are seen showing all grades of depigmentation as evidenced by the different 
