J66 
subdermic tissues are invaded by I.rishmnnm tropica. Almost 
certainly, the parasite, after its entrance has been effected 
mult.phes in enormous numbers. The large non-granular 
mononuclear cells are those which are primarily attracted to the site 
of infection, and they harbour the parasite in large numbers in their, 
interior. Whether intracellular multiplication of the parasiteoccunf 
or not, we have no means of stating with certainty, but it would 
appear probable. 
The skin over the site of infection may or may not show 
hypertrophic changes; in other words, the resulting lesion maybe 
eit icr a prominent centrally ulcerated papilloma, or a slightly 
elevated non-ulcerated patch. In either case, the essential naturi 
, Un “Nitration is the same. We have, unfortunately, 
,, ° to I,la l' w0 any inoculation or cultural experiments with 
the parasite. 
. ^ acts u hi ( h we have called attention may be thus 
summarised: — 3 
nrr (l) Cerlain forms of skin affection caused by Leishmnnia tropica 
occur not infrequently in Egypt. 
almost- y may be solitary or multiple, and in the latter case are 
almost certainly the result of auto-inoculation. 
the snbr,r y COnS,St essentia,, y of a mononuclear infiltration of 
of the parasites! 8 t,SSUCS harbour ’ som etimes, large numbers 
the one themselves clinically under two forms: 
warty^ ^tow h g ^ ra,Sed> flat ^! the other, .-prominent 
by constitutional C ° UrSe ' " d “* UnaCCOm P araed 
(5) They are best treated 
skin-grafting. 
r 
e 
: 
by excision and immediate 
