TRICHOPHYTIC DISEASES 'Under the collective name of trichophytic diseases are embraced a number of affections which Sabouraud has the merit of having described separately and in detail. All the fungi seem to belong to one great family, and their exact description and differentiation should be studied in the text books. It may be mentioned, however, that Sabouraud divides the fungi into endothrix and ectothrix forms, according to whether the fungi or their spores penetrate into the hair or not; he further distinguishes them according to the size and form of the spores and the manner of spore formation (endospores, ectospores), according to whether such formation occurs within or at the end of the mycelia.
(a) GRUBY'S DISFASE This affection, whieh is extremely rare in Germany and Austria, consists in the appearance of several round gray foci of 3 to 5 cm. diame ter on the scalp, which are covered with gray scales. The hairs break off about 6 to 7 nun. from the root and are surrounded by a gray sheath like a cuff. The ntunber of foci are from 2 to 10. This affection com mences sometimes before the third year, rarely after the fourteenth year and has an average duration of eighteen months.
mierosporon Audonini (Gruby, 1S-13).
(b) TRICHOPHYTIA OF CHILDREN'S HEADS This form of the affection begins with a prodromal stage which is very often overlooked. The skin in the vicinity of the scalp exhibits small spots of lentil size and vividly red color which gradually attain a diameter of 1 cm. They heal in the centre while the raised margin spreads peripherally. Often these spots are covered with small ves icles and scales. An examination of the scalp reveals the fact that the hair in a number of places is thinner, the skin at those places is scaly, diseased hair is mingled with the healthy, the broken stubs of the former boring themselves into the scales. Foci of this kind may exist to the extent of several hundred (each eonsisting of a few diseased hairs, sometimes only 3 or 10) or there may be a few larger foci where the diseased hair mingles with the healthy. The hairs are very diffi
cult to pull out and can only be epilatcd singly. Their exterior is smooth; inside they are filled with spores of the trichoplayton endo thrix, breaking and splitting at the affected plaves. The affection extends beyond the period of puberty which has no influence upon it; its duration generally is eighteen months, but without treatment it may last two or three years or even longer. In Paris it is the most frequent form of trichophytic diseases.
affection is caused by a form of trichophyton in which the spores are accumulated in the hair, resembling in their appearance a bag of nuts. The spores of trichophytia endothrix differ from those of the microsporon of Audouin in that they are larger.
Treatment. —The treatment of these two trichophytic affections is disproportionately difficult and absorbs months, because the hair is affected not only at the surface but also at the root involving the root sheaths, and because the hair can only with difficulty be epilated by reason of its breaking off easily in the attempt. To treat the com plaint, the head should be shaved, after Whiell strongly irritating reme dies inay effect the extirpation of the roots (tincture of iodine, oils and ointments containing croton oil). Besides ointments of ehrysarobin and pyrogallus (1 to 1.0 per cent.), applied uncler a firm bandage, can be recommended. In how far treatment by the Rontgen ray will answer the expectations entertained in some quarters, is still uncertain; Sa bouraud believes that the application of the X-ray may shorten the treatment by one-half.