Ringworm - Tinea Circinata
( Originally Published 1927 )
Ringworm of the Smooth Skin (Tinea circinata). —Description. —Ringworm of the smooth skin is not a serious condition, not difficult to cure, but is a menace because it may spread to other parts of the body and be transmitted to others. In this condition the parasites are near the surface. If one were able to look into the top layer of the skin, numerous round or oval bodies and hollow tubes would be found among the horny cells, multiplying and spreading in all directions. These are ringworm parasites and as soon as their presence within the skin is recognized, increased amounts of blood are dispatched to the affected areas. Coincident with this occurrence within the skin, reddened, slightly elevated patches, with rather distinct margins, appear on the skin surface. So far, there is nothing very peculiar to this disease except that the itching is either very slight or entirely absent.
In the course of a very short while, the features peculiar to this affection appear. The older parasites, those residing in the center of the patches, become listless because their nourishment is greatly reduced and little effort is required on the part of the defensive forces of the body to overwhelm them. With their death, the center of the patches becomes flat, loses its redness and scales. This scaling is Nature's way of ridding herself of the damaged cells.
The border of the patch is the scene of greatest activity, for here the parasites are young and vigorous. The defensive forces of the body, recognizing the strength of the enemy, send a larger amount of antiseptic serum to the particular region, both with the idea of overcoming the parasites and of setting up a defensive wall beyond which they cannot pass. Therefore, the border of the patches is elevated, reddened, and, here and there, one sees tiny; blister-like elevations caused by the serum, gravitating into natural canal-like spaces in the epidermis. The fully formed patch of ringworm shows a clear, pale, slightly scaly center, and an elevated, reddened border. As this picture resembles a ring and as the cause was thought to be of the nature of a worm, this disease has been called ringworm. As a rule, only two or three patches are seen at one time. The face, neck, and the backs of the bands are the usual locations for this affection.
Course.—Ringworm of the smooth skin lasts but a short while and is easily cured.
Suggestions for Prevention and Treatment.—As ringworm is contagious, it is of the greatest importance to stop its spread. All the clothing touch. ing the diseased part, and all the towels and linens should be thoroughly sterilized and preferably used only by the infected person. Household pets, such as cats and dogs, can transfer ringworm to humans and this possible source of infection should be investigated. Painting the patches of ringworm with tincture of iodine once a day for six to eight days, or twice a day for three or four days, will often cure the condition. When this fails, consult a physician.
Ringworm of the Groin (Tina cruris).—In this affection, the parasites also invade the top portion of the skin, living, multiplying and spreading among the horny cells. The appearance of the eruption is similar to that of ringworm of the smooth skin, except that the redness is more fiery and the itching much more intense due to the presence of certain irritating factors, such as heat, .moisture, and friction.
This condition begins in the groin with patches of rather large size, of a dull or brownish red color, and with a well-defined, more or less raised border. Soon the center appears pale and some-what scaly, but the border still shows activity. Usually both sides of the groin are affected and the disease may spread rapidly down the thighs and towards the back.
Course.—Ringworm of the groin can usually be cured after a month or two of treatment, but is apt to return unless treatment is continued for some time after the apparent disappearance of the eruptions.
Suggestions for Prevention and Treatment.—As this type of ringworm is contagious and can be transmitted through infected articles of apparel, it is most urgent that all clothing, towels, linen, etc., should be thoroughly sterilized and be used prefer-ably only by the patient. This disease is commonly spread from one person to another by community bathing trunks, jock straps, etc. It is therefore urged that all institutions sterilize their bathing apparel, towels, and other linens instead of merely washing them, as the latter method does not kill the parasites. This condition is therefore common among those who visit pubic bathing establishments, gymnasiums, and similar institutions. Soap and water should not be used on the affected areas, especially early in the course of the trouble, be-cause they may irritate. The treatment requires the services of a skin specialist.
Ringworm of the Extremities.—This condition often exists for months or years, with little or no attention, unless the itching becomes so in-tense as to interfere with comfort and sleep. The feet and hands are the parts that suffer. If the toes of a sufferer be examined, masses of scales, a dead whiteness of the opposing surfaces of the toes, and more or less dampness would be seen. In some instances, the soles of the feet may bear the brunt of the disease and appear studded with blisters, some containing a clear fluid and others containing pus. 'The skin surface itself may be swollen. These blister-like eruptions may also be seen on and between the fingers and on the hands. For a long while, this condition was regarded as a mild eczema but recent investigation has proven that many of these cases are caused by a special variety of ring-worm parasite. - Of course, our treatment of this condition has changed and where previously but few were helped, now many receive quick relief and speedy cure. This was made possible by studying the scales and parts of the blister-like elevations under the microscope and by planting these same substances in special materials (culture media). No long-standing affection between the toes or on the feet, between the fingers or on the hands, in which scales or blister-like eruptions appear, should receive treatment before an examination is made to determine the presence or absence of the ringworm parasite.
Course.—Unless this condition has been long neglected, it yields to treatment in several months.
Suggestions for Prevention and Treatment.—As these parasites can live in the meshes of the hose, it is urgent to sterilize them, before use, to pre-vent reinfection. Treatment requires the services of a skin specialist.