Localization of tricophytosis upon the palms and foot soles is not yet of very common occurrence. Dr. Djelaleddin Moukhtar (of Constantinople) has just studied the question in two communications of much interest, made to the French Dermatological Society. These cases present themselves objectively under the form of raised up epidermic lesions, having the aspect of vesicles of the size of small lentils, not much distended, of a yellow color, little or not at all surrounded by an erythematous zone, and containing a clear fluid. They resemble at first the lesions of dysidrosis. Then these epidermic elevations burst in the centre, disclosing a small surface of a violaceous red color surrounded by a little collar of corneous epidermis, peeled up and dry, beyond which is seen an erythematous circle of a yellowish red and quite limited. This epidermic elevation enlarges progressively by the union of the separate elements, and invades the palm of the hand, the sole of the foot and the neighboring parts of the fingers or toes. At its period of full development the lesion is constituted by a plaque of polycyclical contour, over which the skin is red, furfuraceous, and covered at its periphery with horny scales, presenting the aspect either of a tertiary circinate palmar or plantar syphilide, or of erythematous or pemphigoid elements. Microscopic examination of the horny masses, taken from several points of the border of the lesions, permits the diagnosis (with the aid of potassa) of mycelian filaments of the trichophyton tonsurans. It is thus necessary in future, when we have before us a polycyclic dermatosis of syphilitic aspect, unilateral, of the palm of the hand or foot sole, not to hasten to the conclusion that it is a tertiary syphilide, but to first practice an histological examination and search in the horny scales of the border of the patch the trichophyton tonsurans.
J Cutan Genito-Urin Dis.
Trichophytosis of Regions Covered with Thick Corneous Epidermis. Arch Dermatol. 1992;128(7):1010. doi:10.1001/archderm.1992.01680170146038