An American text-book of genito-urinary diseases, syphilis and diseases of the skin . dy of the nail. .. Pellizari,2 who reports the remarkable frequency of 20 cases in loO ot allvarieties of tinea trichophytina, gives the main features of the disease asfollows : The first apparent change is in the color of the nail, which becomesspotted or striated with whitish, lusterless areas which are sometimes split or 1 Fournier: Journ. des Makid. cut. d syph., 1889, t. i. p. 3. 2 Pellizari: Bicerche s. Trichoph. tonsur., Milano, 1888, iv. p. 17. 1146 DISEASES OF THE APPENDAGES OF THE SKIN. ridged. Some
An American text-book of genito-urinary diseases, syphilis and diseases of the skin . dy of the nail. .. Pellizari,2 who reports the remarkable frequency of 20 cases in loO ot allvarieties of tinea trichophytina, gives the main features of the disease asfollows : The first apparent change is in the color of the nail, which becomesspotted or striated with whitish, lusterless areas which are sometimes split or 1 Fournier: Journ. des Makid. cut. d syph., 1889, t. i. p. 3. 2 Pellizari: Bicerche s. Trichoph. tonsur., Milano, 1888, iv. p. 17. 1146 DISEASES OF THE APPENDAGES OF THE SKIN. ridged. Sometimes the whitish discoloration is limited to one side of thenail, in which case the border involved is liable to curl upward. After sev-eral years the nail becomes of a yellow color, thick and irregular. Thesuperficial part of the nail is the last to become involved. Pathology and Anatomy.—This has also been studied by Pellizari,who found the trichophyton in the nail-bed, and especially as the free borderwas approached (Fig. 278). In the neighborhood of the matrix of the nail. Fig. 278.—Onychomycosis trichophytina. the epidermic cells contained eleidine in place of onychogene; this retro-gression is due to the inflammation present, which further gives rise tothickening of the nail and loss of its natural pinkish color. Numerouscavities were also found between the lamella? containing the trichophyton,which gives rise to the whitish spots and lines previously referred to. It wasalso found that the trichophyton penetrated into the subjacent derma. Diagnosis.—The disease must be differentiated from both eczema andpsoriasis ; lichen ruber also affects the nails. The main point of distinctionlies in the more general distribution of these diseases when affecting the nails;whereas onychomycosis is generally limited to one or two nails, and then onlyone part of the nail may be involved. Again, the various affections men-tioned are usually distributed over other parts, where their
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Keywords: ., bookcentury1800, bookdecade1890, booksubject, booksubjectsyphilis
