Hormonal Dysfunction in Adults Infected With Ringworm of the Scalp Due to Trichophyton

Abstract

Systematic examinations — involving the population of districts in Bosnia where mycosis is endemic — resulted in establishing the fact that superficial Tinea capitis due to trichophyton (Tr. violaceum) as a rule occurs in adults as well, mainly in those of female sex (Grin).

The morbidity-rate tends to decline sharply in males after the age of sixteen, while remaining stationary at a certain level in females of all age groups, the majority of the cases, however, occur in prepubertal and preclimacteric period, and in the climacteric as well.

This can be seen from the data — tabulated in Table 2 — collected in an endemic area where 10,534 people were subjected to a systematic examination. Of the above total, 795 persons were found to have ringworm of the scalp caused by trichophyton, the recorded incidence of morbidity being 75.5 per thousand. In females of the age-groups 6—10 and 51—55 the morbidity-rate was 107.9 and 78.8 per thous. respectively, as compared with 92.7 and 100 per thous. of the age-groups 56—60 and 61—65.

Since Tinea capitis due to trichophyton after puberty had been found to occur mainly in females, examinations of adult patients were made to test the quantity of androgen secreted in the urine and in respect of psychosomatic properties likely to bear upon the functioning of hormones.

One group of adult patients were tested for androgenic substances by biologic method (38 cases aged 18—72), and the other (17 females aged 18—53) for 17 keto-steroids by colorimetric method.

Experiments with rats showed that quantities of androgenic hormones in the urine were not large enough to be determined by biologic method. The quantity of 17-keto-steroids in the urine, on the other hand, vas found in general lower than the normal values, the average rate being 8.17 mg. in 24 hours.

The generative function was intact in all the women involved. As regards psycho-somatic properties (88 women and 24 men between the ages of 17 and 70) the majority of patients were of retarded somatic development with infantile features and characteristic peculiarities of obviously protracted puberty. Most of these were gracile-leptosome types, the špan of outspread arms being as a rule longer than the height of the body (up to 43 cm).

A number of male adults showed somatic changes characteristic of certain dysfunction of hormonal glands, such as the absence of axilary and pubic hair — signs of a disturbed andreno-cortical function — as well as gynecomastia. As many as 61 percent, of the male adults had a female pattern of pubic hair with the horizontal line upward.

It seems impossible as yet to say with any certainty what disturbance of the mechanism in the complex endocrine-neuro-vegetative system is responsible for the decreased resistance to fungal infection of the scalp in certain groups of adults; nevertheless, on the basis of observations made up to date it is to be supposed that we are concerned with a disturbed adrenocortical function of androgen-oestrogenous balance.