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Bryan Applications, R

Certain affections, due to the presence of parasitic fungi, are described as ringworm. The fungi, are propagated by little round or oval bodies known as spores. The variety of the infection depends upon the spores and, when it occurs in a hairy situation, upon their position, whether they are on the surface of the hair, within its substance, or both.

A fungus that produces small spores is called a microsporon; one that produces large spores, a megalosporon, or trichophyton. Of the latter, one in which the spores are within hairs, referred to as an endothrix, and another in which they are both within and on the hairs, an endo-ectothrix, are, apart from the microsporon, the common parasites in human ringworm. The lesions of ringworm are commonly rounded or oval, the disease spreading out in all directions from the center. Ringworm may be found on the scalp, the beard, non-hairy parts of the body, and the nails.

Ringworm on the body:

Ringworm of the body, or tinea circinata, may occur in children suffering from ringworm of the head or in adults who come into close contact with domestic animals. The usual cause is a trichophyton. A reddish patch forms on the skin, and as it spreads at the edges the central part tends to heal. The margin is somewhat raised, and is covered with glistening scales. The course is rapid. Treatment consists in painting with tincture of iodine for three or four days and then applying an ointment consisting of 1 drachm of white precipitate ointment with soft paraffin to make 1 ounce, or a similar preparation. Clothing which has come into contact with the diseased skin must be carefully disinfected.

Ringworm of the beard, or tinea barbae, is usually caused by the trichophyton ectothrix, was once also known as Barber’s Itch.

Ringworm of the scalp, tinea tonsurans, is almost entirely confined to children usually such as are of school age. The commonest cause is microsporon audouini. In this type there are one or more patches, slightly reddened and covered with grayish scales. The hairs within the patch are lusterless and many of them are broken. In the type known as suppurative ringworm, or kerion, there are large, raised patches from which pus exudes at many points. This is usually caused by the endothrix parasite. In a third type, known as black dot ringworm, there are bald patches resembling those found in the variety of baldness “(q.v.) called alopecia areata, but the scalp within the areas is stippled over with small black dots,representing hair stumps. This type is caused by the endothrix parasite. It is difficult to cure, but is not common.

As regards treatment, it may be said that kerion tends to cure itself, the suppuration loosening the hairs and causing them to fall out. The patch should be painted with tincture of iodine, however. Epilation can be accomplished in other forms of ringworm by exposure to X-rays, though this should be at the hands of an expert. When the hairs come away they bring the infection with them. When X-ray treatment is not available, the scalp should be shaved weekly, though if there is only one patch it may suffice to shave this and for about half an inch around it, while the remaining hair is clipped very short. The patches then have a colorless iodine ointment, such as unguentum iodin denigrescens, rubbed into them daily. This treatment must be continued for a long time. Other forms of treatment by drugs, if handled by experts, may produce a more rapid cure, however.

The patient should wear a cotton cap which is frequently disinfected by boiling, and should on no account use brushes or towels common to the household. Other children in the house should have their hair clipped short, and it is a useful precaution to rub the colorless iodine ointment into their heads also.

Ringworm of the nail may be due to extension from the hand or to handling other affected parts, being not uncommon, for this reason, in nurses. It is caused by a trichophyton. The nail, which becomes dull yellow in color and ridged, is raised off its bed by a grayish-looking mass. It is very brittle, and usually looks irregular, from pieces having been broken off.

The only treatment is to remove the nail and kill the parasite in the nail-bed by painting with tincture of iodine.

Application and treatment:

The treatment of ringworm may be accomplished by means of electrode pad placement all around the affected area. One pan on either side of the ring, and moving the pads in such a way as to ensure that all parts of the area have been thoroughly treated is recommended. Rapid reduction in symptoms will be quickly evident, however there may be itching and sudden rash, as though the disease were about to proliferate prior to its diminution. This is a very common effect of frequency and is no cause for alarm unless it is not followed within 3 sessions by very dramatic relief.