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During 1927, of the specimens of hair stumps sent in by the school nurses, 1,872
were examined in the Council's laboratory and of these 653 contained ringworm fungus
(550 small spore and 94 large spore) and 9 proved to be favus.
Three fresh cases of favus were discovered during the year, whilst 5 cases
remained uncured, making a total of 8 cases under treatment, all of which were cured
during the course of the year.
It has been recognised for some time past that ringworm is a generic title for
a variety of skin affections which are due to different forms of fungus, which, although
related, are quite distinct from each other, just as the tea rose, for example, is
different from the rugosa. One form of ringworm can only be produced by the same
species of fungus. In this connection valuable observations have been made during
the past year.
The fungi of ringworm may affect either the hairy scalp, the beard or the smooth
skin. From a school point of view scalp ringworm is by far the most important
variety, and adults, except those coming from a tropical country, are generally
immune from the disease. The consequent inflammation or dermatitis of these
fungi may differ in various individuals, depending not only upon the fungus but
on the age of the person or on special peculiarities generally referred to as " idiosyncrasies."
These parasitic affections may be manifested by a superficial scaly
patch, or they may produce eczematous, pustular or granulomatous lesions. Two
years ago Dr. J. A. H. Brincker, when investigating an outbreak of ringworm in
a girls' residential school in the country affecting some 30 of the girls, found three
entirely different types of fungus—the conclusions arrived at were that there were
at least three different sources of infection. Recognition is due to Messrs. J. G.
Hare and P. Tate, of the Molteno Institute for Research in Parasitology,
Cambridge University, for the identification and classification of ringworm
specimens from London school children, and a short summary of their report is
here given.
The fungi producing this group of skin diseases belong to the botanical class
called Fungi Imperfecti and to the natural order Thallospirales. To this group also
belong other fungi, notably the monilias which are known to produce disease in
the human being. The ringworm fungi generally belong to two sub-orders of the
Thallospirales, namely—
I. True Thallospirales.—The pityrospirum or bottle bacillus which produces
a disease simulating ringworm; it also affects the skin, nails and hairs, often
producing a bulbous swelling, at which the hair splits or breaks off; this is
known as Trichorexis nodosa. A case of persistent affection of the nails produced
by this fungus was demonstrated in one of the children attending a school
in Fulham.
II. Sub-order Arthrospirales—(&) Favus types.—These are produced by the
genus Achorion. In London school children only one species has been identified,
(b) Large Spared type.—This variety is produced by the genus Trichophyton, which
produces 17 per cent. of all the cases in London schools. Four species have been
identified, namely—T. crateriformi, 41 per cent. of all large spore. T. acuminatum.