1968 Volume 37 Issue 3 Pages 247-258
Observing the leprosy patients, there were noted a good number of patients with a peculiar eroded, macerated changes in the interdigital spaces of their hands. The condition was tentatively named as Erosio interdigitalis. In an attempt to clarify the resson as well as cause of occurrence of such a condition, a clinical statistical observation and a clinical bacteriological study have been carried out, and it was found that the condition was very much the same with the Erosio interdigitalis blastomycetica condition noted in general in dividuals. The results obtained in the studies were as follows.
1. 430 leprosy patients (250 male, and 180 female) were clinically observed in summer giving the following results:
1) The occurrence incidence of the condition was 21.2% (91 positive cases among the 430 leprosy patients investigated).
2) As to sex, it was noted that the occurrence incidence in male was 14.8% (37 positive among 250), while in female it was 30% (54 positive among 180), the incidence being significantly higher in female.
3) As to age, it was noted that the occurrence incidence increased with age up to the sixth decade, and thereafter showed significant decrease. The incidence in the sixth decade was in male 22.4% (13 positive among 58) and in female 50% (17 positive among 34).
4) As to hand, there was no significant difference noted between the occurrence incidence of the condition in the right hand and in the left hand.
5) As to site of predilection, the condition was noted to occur the most frequently in the 3rd interdigital space, and then in the order of the 2nd interdigital space, the flexural aspects of the finger joints, the 4th interdigital space, and the least frequent in the 1st interdigital space. The number of hands in which the 3rd interdigital space was affected with the condition were 28 among the 47 positive hands (59.6%) in male, and 62 among the 79 positive hand (78.9%) in female.
6) As to the relationship between the occurrence incidence of the condition and the grade of deformity of the hand and fingers, it was noted that the occurrence incidence was the more higher the greater the grade of deformity of the hand and fingers was. However, when the deformity was so severe as to become mutilated, the occurrence incidence was noted to significantly decrease. The degree of severeness of the condition showed similar 247 248 1968 trend with the grade of deformity of the hand and fingers, however, it was not significant.
7) As to the relationship between the occurrence incidence of the condition and the type of leprosy, there was no noticeable significant difference between the occurrence incidence of both the types, the lepromatous and the tuberculoid leprosy.
2. Further the occurrence incidence of the condition was investigated in winter among 292 leprosy patients (183 male, and 109 female), and it was noted that 10.6% had the condition. In male it was 6.6%, and in female it was 17.4%. They were all found to be significantly lower than the occurrence incidence of the condition investigated in summer respectively.
3. Clinical bacteriological study was made with 22 patients (26 sites) as subjects, and the followings were revealed: Candida albicans were detected in 84.6% (22 sites positive among the 26 sites), among which 77.3% (17 sites among the 22 sites) were found to be mix-infected with Staphylococcus aureus, Escherichia coli, or Pseudomonas aeruginosa.
Taking the above-mentioned results into consideration, the pathogensis of erosio interdigitalis in leprosy patients was assumed to be as follows: In leprosy patients, due to deformity of the hand and fingers, the interdigital spaces as well as the flexor aspects of the finger joints stick closely together, and then, because of uncleanliness and undryness, they may be infected with Candida albicans or mix-infected with Candida and Staphylococcus aureus or other pathogenic microbes,
