PubMed · 12756316
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Ramyar Moussavi. Lichen planus. A case study.. https://doi.org/10.7547/87507315-93-3-238
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We report an unusual case of tuberculosis verrucosa cutis on the plantar aspect of the foot that had been present for more than 40 years in a 62-year-old Indian man. He had a grade IV positive Heaf test and a normal chest radiograph. Mycobacterium tuberculosis was successfully cultured from the third biopsy taken from the lesion. This case demonstrates the indolent nature of the lesion and stresses the importance of taking adequate biopsies for microbiological culture when there is a high index of suspicion for M. tuberculosis. The diagnosis of tuberculosis verrucosa cutis should be based on history and evolution of the disease, cardinal morphological features and histopathological characteristics. Response to anti-tuberculosis drugs may be of assistance.
Onychomycosis is common, affecting approximately 5% of the population, and is the most resistant form of superficial fungal infection. Dermatologists often view the nail apparatus in static terms and unfortunately give little consideration to the functional aspects of the digit. In the case of toenails, it is important to consider the toes and foot as a closely integrated functional unit. It is essential that in any case of onychomycosis or onychodystrophy that, as clinicians, we have an understanding of foot dynamics, of structure/function relationships and of the implications of orthopaedic/podiatric factors when evaluating cases of nail dystrophy. When confronted with cases of possible onychomycosis, we must adopt a systematic and sometimes multidisciplinary approach in the evaluation and management of these patients to improve patient outcomes.
Solitary mastocytoma is an uncommon disease characterized by monotonous infiltrations of mast cells that extend from papillary dermis to subcutaneous fat. They usually resolve by adulthood, and there is no satisfactory treatment other than waiting. A two-month-old Korean male infant with deep solitary mastocytoma was treated intralesionally with triamcinolone acetonide. His mastocytoma in medial malleolus was very distressing because it was very sensitive to friction, and he was just reaching the crawling stage. After three injections, his skin lesion flattened with marked decrease of erythema and subjective symptoms. His skin lesion has continued to have a good clinical response for 9 months after the last treatment.