Home >> Practical Treatise On Disease In Children >> Pseudo Hypertrophic Paralysis to True Sclerema >> Tine Favosa

Tine Favosa

crusts, disease, hairs, favus, tinea, stage, colour and tonsurans

TINE& FAVOSA.

Tinea favosa, or favus, is much less common in England than the pre ceding. Like it it is a contagious disease, and is most frequently seen in scrofulous or neglected and badly-fed children. It is said to be common in some countries in mice and rats, and instances have been known in which the disease has been conveyed from these animals to the children of the family.

Favus is due to the presence of a cryptogam—the achorion Schoenleinii. The mycelium and spores of this fungus may be seen without difficulty if a portion of the crust be put under the microscope, moistened with a drop of Eq. potassm.

Symptoms.—Like tinea tonsurans, favus may occur on any part of the body, but is usually met with on the head. It begins in small scaly patches which cause much itching. In this early stage the disease bears a close resemblance to the ordinary ringworm, especially as the hairs grow incf on the diseased spot quickly lose theirlustre and get dull in colour. They do not, however, as in ringworm, become brittle, so that there is no difficulty in pulling them out with the forceps.

After a time small yellow crusts of about the size of a pin's head appear on the patch round the hairs. These crusts are at first convex, but after wards as they enlarge become cup-shaped. They are of a sulphur-yellow colour, and vary from a split pea to a mass of the diameter of half an inch. Usually one or two hairs pass through the centre. At first the favus crusts are placed singly, but they may afterwards become confluent, so as to form irregular-shaped masses, more or less extensive, and without the character istic cup-shaped depression. The smell of the head covered by the crusts is very unpleasant and somewhat resembles that of mice. On the removal of a favus crust a depression is seen which is red and may be ulcerated. This, after a few days, disappears and the surface becomes again covered by a new crop of cup-shaped'crusts. • 'When the crusts become detached and fall off spontaneously the skin is merely seen to be stained of a dark red or violet colour. As the disease goes on the hairs lose their natural tint, and glow loose in their sockets so as to be pulled out with ease. Their shafts are found on inspection to be irregular in their diameter at differ ent points, and their roots are atrophied. They become fewer in number, and if the disease persists may disappear altogether, leaving the part com pletely bald.

On the body favus, like tinea tonsurans, forms rings, but these always remain small, seldom exceeding half an inch in diameter, and have not the characteristics of tinea circinata. In other respects they bear a close re semblance to that disease. Afterwards, however, the characteristic crusts make their appearance at the edges and on the surface of the rings.

the disease is well developed on the scalp, the cup shaped crusts, and their sulphur-yellow colour are very characteristic. It is in the early stage before the crusts appear, and in the later stage when the crusts have lost their peculiar features, that the disease is liable to be mistaken. In the early stage the round, itching, scaly patches closely resemble common ringworm, but a distinction is supplied by the want of brittleness of the hairs in favus. In this disease the hairs can be pulled out of their follicles with ease, while in tinea tonsurans, if an attempt be made to extract the hair, it almost invariably snaps short off close to the scalp. In the later stage when the crusts have lost their distinctive char acter, especially if, as often happens, they have become complicated with a secondary eczematous eruption, the diagnosis is again less obvious, but the history of the case, and a careful microscopic examination of the crusts, which reveals the mycelium and spores of the cryptogam, will indicate the nature of the case.

crusts must be removed by saturating them with olive oil, and then poulticing, or by constantly applying a strong sulphurous acid lotion under a cap of oiled silk. When the scalp is quite denuded of crusts and scabs the hair must be cut close to the skull, and steps can then be taken to remove all the hairs from the diseased surface. This is a work requiring much time, trouble, and patience ; for each hair must be carefully extracted by the forceps, taking care to pull in the direction in which the hair is growing. When this has been done; the special remedy must be well rubbed into the scalp. Any of the applications recommended for tinea tonsurans may be made use of, but one of the most effectual is the oleate of mercury ointment (five per cent.). This must be used care fully and with precaution that the ointment does not run over the face.

If the child be badly nourished or anaemic, strengthening medicines and good nourishing food will be of service in aiding his recovery.