Page:Tropical Diseases.djvu/950

892 has been seen in North Africa,* in Egypt, and possibly in the Malay Peninsula. Symptoms.— Pinta commences at one or two points, the rest of the surface of the skin becoming infected in turn by extension or by auto-contagion. At first the hands, or face, or some other exposed parts, are attacked. The original patch may be white, red, blue, or black. It gradually increases in size, becoming scurfy and itchy, particularly when the surface is warm. As the patches spread they assume a variety of shapes. Fresh spots appear in the neighbourhood of the parent spots, into which, in course of time, they tend to merge ; so that ultimately large patches of discoloured skin are formed. The palms of the hands and the soles of the feet are not attacked. On the scalp becoming affected the hair turns white and thin, and ultimately falls out. When fully developed, the disease produces a very grotesque appearance. It is probable that the white patches in a proportion of cases are not epiphytic, as they neither itch nor desquamate; very likely they are ordinary leucodermia, possibly brought about through disturbance of the natural pigmentation by a parasite which had subsequently died out. Sensation and the glandular functions of the skin are not affected. In consequence of the scratching, the implicated parts may become cracked or ulcerated.

Two types of the disease have been named the superficial epidermic and the deep epidermic; the former being represented by black and blue patches