The patient, E. W., entered the Barnard Hospital on May 7, 1914, complaining of a pruritic condition of the vulva. She was a negress, aged 46, fairly well nourished, and found to be clinically healthy except for a ++++ Wassermann reaction and the skin condition from which she suffered.
She stated that the disease began on "an irritated spot" on the inner side of each thigh, about December, 1913, and that these spots increased in dimension until they occupied the areas at present involved.
On examination, about the upper part of the thighs, sweeping out from each side of the vulva, extending farther on the right than on the left, was a sharply defined, scaly area, the exact location of which can be seen in Figure 1. The condition looked exactly like that of a tinea inguinalis or that produced by Epidermophyton inguinale. One could not have differentiated this infection from