Epidermophytids as a Clinical Conception

Trichophytid as a clinical conception was first introduced in 1908 by Jadassohn, 1 who described lichen-like lesions on the trunk in patients with trichophytic kerion lesions on the scalp. These were associated with systemic symptoms and with a positive reaction to trichophytin. Later Bloch 2 confirmed and elaborated this conception on an immunologic basis by reproducing the condition experimentally by injections of trichophytin. He also described other types of lesions, such as scarlatinoid. erythema multiforme, nodular and pustular. Several other observers, among them Brash, reported similar lesions and supplied more immunologic evidence. Sutter 3 demonstrated fungi in lymphatic glands, and Bruusgaard 4 found fungi in the sections of small veins. All these studies, however, were made in cases of deep trichophytosis, mostly of kerion type. In 1911 Sabouraud 5 for the first time isolated epidermophyton fungus from the superficial eczematoid vesicular and scaly intertriginous lesions of the toes.