300 REPORT OF THE HARVARD AFRICAN EXPEDITION 
pear after local irritation, for example from any dermatitis or the wearing of a 
tight belt. The commonest form seen by us, however, was of the type described 
as idiopathic vitiligo, an instance of which is illustrated in Nos. 275-276 (Case 
389). In this case there were widespread pinkish-white patches on the hands, and, 
to a less degree, on the feet. The palms and the heels were also markedly affected 
but the largest lesion extended along the inner side of the right arm from the 
palm nearly to the elbow. There were small depigmented patches along the 
edges of the larger white areas and scattered over the body. A patch on the lip 
included part of the mucous membrane of the lip and of the gum. The skin of 
the back appeared normal in every respect save in color. On the depigmented 
areas on the forearm, the skin was of normal texture but exhibited irregular areas 
which were faintly reddish in color. On the hands the skin seemed to be thick- 
ened and of abnormal texture. In some areas there was slight scaling. On the 
palms and in the folds and about the joints there was more scaling and exfolia- 
tion of the horny layer, and pitting of the surface of the skin. Scrapings from the 
skin examined in potassium hydroxide solution showed no mycelia or spores of 
fungi. In stained preparations of scrapings made from the skin, the same result 
was obtained. Histological study of sections of skin from this case also show that 
the process is one of true vitiligo and that no fungi are present. In fact, the 
sections show no pathological changes with the exception of the absence of pig- 
ment. There is not only loss of pigment in all the chromophores but also the 
whole area of skin in the affected patch takes a much paler stain in comparison 
with the normal skin seen at the edge of the tissue. Very few pigment-contain- 
ing wandering cells are present in the cortum. There is nothing from the micro- 
scopical or histological study to suggest that the affection is parasitic or infectious 
in origin. 
Albinism (No. 277) was also observed in individuals with dirty, white, trans- 
parent skin and yellow or yellowish white or reddish-white hair. These patients 
usually appeared to be in poor physical condition, apathetic and afflicted with 
photophobia and nystagmus. Such cases of albinismus universalis are usually 
regarded as congenital. 
Seborrhoea. Patches of seborrhoea were also observed, particularly on the 
backs and shoulders of natives in Liberia. Scrapings from these lesions usually 
showed a few yeast cells, sometimes free and sometimes enclosed within epithelial 
cells. It is so frequent, however, to find yeast cells in the superficial scrapings 
of the skin of Africans, that in many instances it was not clear to us that they 
had any significance of importance. In some cases in which we found yeast cells 
in scrapings from the skin, the histological study of the tissues made later did 
not show the presence of these micro-organisms (Cases 192 and 410, Nos. 278— 
279). Obviously their invasion of the epidermis was very superficial. 
Acton and Panja' have recently made an extensive study of seborrhoea 
dermatitis or pityriasis in India. They point out that the large yeast-like organ- 
isms that bud, and the spores of malassez, or the flask bacillus of Unna, and the 
gray coccus or morococcus which have been described by Sabourraud in sebor- 
? Acton and Panja: Indian Med. Gaz. (1927), LXII, 603. 
