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A Histopathological and Histochemical Study

JAMES H. GRAHAM, MD; WAINE C. JOHNSON, MD; CARROLL F. BURGOON, JR., MD; ELSON B. HELWIG, MD

Arch Dermatol. 1964;89(4):528-543.

Abstract
A histopathological and histochemical evaluation of biopsy material from 53 patients with tinea capitis due to Microsporum audouini, Trichophyton schoenleini, Trichophyton tonsurans, Trichophyton sulfureum, and Trichophyton violaceum shows fungal elements rich in polysaccharides. An abundance of hyaluronic acid is present in the stroma, in the outer root sheath of anagen hair follicles, and around the fungal elements in M audouini and T schoenleini infections. It is shown that the latter two organisms cause endo-ectothrix infections, and the other dermatophytes in the study are true endothrix parasites. Observations suggest that the survival and propagation of the dermatophytes is pH dependent, and this may be related to the presence of large amounts of hyaluronic acid. The noninflammatory clinical appearance of infections due to M audouini contrasts sharply with the intense histopathologic changes.

Author Affiliations
PHILADELPHIA; WASHINGTON, DC

Associate Professor of Dermatology and Associate Professor of Dermal Pathology, Temple University School of Medicine, and Director of Laboratory, The Skin and Cancer Hospital of Philadelphia (Dr. Graham); Assistant Professor of Dermatology and Assistant Professor of Dermal Pathology, Temple University School of Medicine, and Research Pathologist and Assistant Director of Laboratory, The Skin and Cancer Hospital of Philadelphia (Dr. Johnson); Professor and Chairman, Department of Dermatology, Temple University School of Medicine, and Medical Director, The Skin and Cancer Hospital of Philadelphia (Dr. Burgoon); Chief, Department of Pathology and Branch of Dermal Pathology, Armed Forces Institute of Pathology, and Visiting Professor of Pathology (Dermal Pathology), Temple University School of Medicine (Dr. Helwig).

From the Skin and Cancer Hospital of Philadelphia, Department of Dermatology, Temple University School of Medicine, Philadelphia, and The Armed Forces Institute of Pathology, Washington, DC.

Footnotes
Read before the Section on Dermatology at the 112th Annual Meeting of the American Medical Association, Atlantic City, NJ, June 17, 1963.

This investigation was supported in part by research training grant No. 2A-5289 (C1), from the National Institute of Arthritis and Metabolic Diseases, Public Health Service, Bethesda, Md.

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