Disease due to fungi
Thrush
Thrush is a fairly common affection occurring in the mouth in bottle-fed infants. White patches are seen on the tongue and lining membrane of the mouth, and the child will probably have sore buttocks. Scrupulous attention should be paid to cleanliness of bottles and teats, these being boiled after each feed and kept immersed in cold boiled water between feeds. The patches in the mouth should not be cleaned after the child has had a feed.
Thrush infection sometimes occurs in adults, especially in the genital areas, causing a form of intertrigo. It may also cause peeling and oozing between or beneath the toes, or give rise to white leathery patches the fingers.
These eruptions may be treated by local application of nystatin ointment or crystal violet (gentian violet) solution, while nystatin tablets may be given by mouth. For infants, nystatin suspension may be applied to the inside of the mouth three times daily.
Occasionally thrush round the nails is seen in housewives or cooks, the areas being swollen, red and tender, the condition tends to be chronic unless the hands are kept dry. A 2 per cent solution of crystal violet (gentian violet), or a 1 in 1,000 solution of proflavine should be applied and sometimes X-ray treatment is use din very chronic cases.
Dandruff
(Seborrhcea Sicca)
Dandruff or scurf is a mildly infectious disease of the sebaceous glands of the scalp, characterized by the copious production of horny white or yellow scales. The secretion may be so thick as to mat together the hair, or so dry as to fall off the head in a shower when the hair is combed. It is a common cause of early baldness, especially of the temple and crown, and causes irritation of the scalp; seborrhceic dermatitis may develop on other parts of the body. There is often reddening of the forehead along the margin of the hair. The heads of babies may be infected soon after birth by scales of dandruff from the mothers hair.
Treatment
Should the amount of scales be considerable, especially if there are crusts as in the case of small children, the best procedure consists in oiling the scalp overnight with olive oil, and washing off the oil in the morning with soft soap and water. The scalp needs a shampoo two or three times a week with selenium sulphide solution (Selsum). For excessive oiliness, a 10 per cent solution of sodium sulphacetamide is excellent. A more chronic case may require resorcinol lotion or ointment.
Ringworm
(Tinea)
The different forms of ringworm are due to various fungi which may attack the scalp, body, skin or nails. The varieties more commonly seen are:
TINEA CIRCINATA, in the body;
TINEA TONSLIRANS (capitis) in the scalp;
TINEA BARBIE, in the beard region.
A rarer form called tinea cxutus or dxobt itch occurs in the groins and thighs, while tinea redts is well known as athletes foot and the nails may be affected by Tinea, TI gium.
On the body the lesion may be popular, in pink scaly rings, nodules, or plaques. On the scalp it usually occurs in children; the incubation period is up to two weeks and the patch begins as a pink area with scales around the hairs which are dry and broken and can easily be pulled out. It must be borne in mind that there may be associated eruptions such as seborrhea or impetigo which may mask the ringworm appearance. The disease tends to disappear spontaneously at puberty, but occasionally alopecia areata follows.
Treatment
Treatment of ringworm of the scalp necessitates isolation and segregation of the patients towels and toilet articles. The hair should be cut close over the affected area. All older treatments have been superseded by griseofulvin, and antibiotic derived from strains of Penicillium, which is given by mouth as tablets for three to six weeks. As the new hair grows in, it is then resistant to the fungus.
For the body variety of ringworm the crusts and scales must be removed and the area rubbed will with sulphur and salicylic acid ointment. For ringworm of the toes, the region should be soaked in potassium permanganate solution and painted with castellanis paint; a fungicide powder, such as Tineafax, is then dusted on.
Favus
Favus is also a contagious fungus disease producing yellow cup-shaped crusts which first appear on the scalp and may spread to the body. The patches tend to coalesce, and form a mass like a honeycomb; an unpleasant odour of mice or of a musty nature is characterise. The hair is very dull, but does not break as easily a in ringworm. Bald areas, however, are produced in time and the disease often proves very intractable. The treatment is again to prevent contagion, while an ointment containing mercury, salicylic acid, and resorcinol in lanolin is used, the crusts being removed with olive oil, and a soap and spirit shampoo given. Like ringworm, favus responds will to griseofulvin.
Compiled by
Dr F. I. Biswas
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