Biomedical subjects
Publications and source records attributed to O J Stone.
A patient with a leg ulcer and edema of her foot had onychogryphosis. Although onychogryphosis is usually thought of as permanent, correction of the leg ulcer and edema permitted regrowth of a structurally normal nail.
It is as simple to biopsy around the nail as it is at any other site, and there are multiple lesions that deserve biopsy. Biopsy of the nail bed or nail matrix is avoided unless there is possible malignant change. Biopsy sites in the nail bed usually heal satisfactorily, but biopsy of the matrix is more likely to produce permanent deformity.
An eighty-one year old man is presented who had multiple (four) premalignant fibroepitheliomas of Pinkus. A review of the literature and our case material revealed that multiple lesions account for 36 percent of the total cases reported. The clinical and pathologic features of these unusual variants of basal cell carcinoma are discussed.
A 71-year-old man, who had a history of a previous bullous drug reaction to a sulfonamide, began receiving an ophthalmic preparation that contained sulfacetamide sodium. The patient received only the ophthalmic sulfonamide, and it was used for one day, but he developed Stevens-Johnson syndrome. This is believed to be the first reported case of Stevens-Johnson syndrome caused by an ophthalmic sulfonamide. The sulfonamides are the best verified drug-trigger for erythema multiforme and Stevens-Johnson syndrome.
Two overweight male patients developed acanthosis nigrican of the axillae. Seven to nine months later, the patients developed hidradenitis suppurativa deep within the areas of acanthosis nigricans. On examination of biopsy specimens, the hyperkeratosis of acanthosis nigricans was found to extend into the follicles. In previous reports, Fox-Fordyce disease and pityriasis rubra pilaris have preceded the onset of hidradenitis suppurativa.
A patient who worked as a baker and a part-time barber had chronic paronychia. Biopsy revealed the presence of hair in the dermis of the nail fold. This is only the second case of chronic paronychia to be reported in which the dermis contained nonmicrobial exogenous material. Based on experimental work it has been previously suggested that the rounding out of the posterior nail fold in most paronychia is due to the body's reaction to the penetration of debris derived from Candida albicans. However, patients recalcitrant to therapy or those exposed to chemicals or particulate material deserve detailed histologic study.
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