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PubMed2005

Clinicopathologic features of epidermal cysts of the sole: comparison with traditional epidermal cysts and trichilemmal cysts.

BACKGROUND: It has been described that the etiology of epidermal cysts on acral skin is different from that on non-acral skin; however, no papers have been published regarding the detailed histological differences between acral and non-acral epidermal cysts. In this study, we compared the clinicopathologic findings of epidermal cysts of the sole with those of traditional epidermal cysts and trichilemmal cysts. METHODS: The cases studied were 12 epidermal cysts of the sole, 35 traditional (non-acral) epidermal cysts, and 12 trichilemmal cysts. The age and sex of the patients and the site, size, and microscopic findings of the lesions were evaluated. The pattern of keratinization was specifically focused on the evaluation of microscopic findings. RESULTS: Microscopically, most of the epidermal cysts of the sole showed the presence of parakeratosis and focal lack of a granular layer at least at the upper portion of the cyst wall. The cyst content of the epidermal cysts of the sole was predominantly compact orthokeratotic material. These pathological findings could be explained by the pathogenesis of epidermal cysts of the sole, namely invagination of the surface epidermis. CONCLUSION: Our study indicates that most cases of the epidermal cyst of the sole are considered to be a true traumatic epidermal inclusion cyst.

Adolescent↗
PubMed1976

Skeletal lesions of the feet in diabetics and their relationship to cutaneous erythema with or without necrosis on the feet.

Seventy patients with cutaneous erythema of the feet with or without necrosis were the subjects of this investigation. Sixty-five of them had open diabetes. The glucose tolerance of the remaining five patients was altered in a diabetic direction. Twenty-seven of the 70 patients had roentgenologically demonstrable destruction in the bones of the feet. These 70 patients were compared with 61 diabetic control patients of corresponding age and duration of diabetes but without these skin lesions of the feet. Only four of the 61 control patients had destruction in the bones of the feet and all these destructions were small. Precipitating factors were identified in general for the skin lesions, the most common being cardiac decompensation. A higher frequency of precipitating factors was seen in patients with skeletal destructions than in those without. The skeletal destructions and cutaneous necrosis are supposed to be equivalent lesions, localized to different tissues in the feet. When patients presenting skin lesions of the feet in the form of distal gangrene were compared with those who had cutaneous erythema and necrosis of the feet, but no distal gangrene, no differences were found with respect to age, duration of diabetes, occurrence of precipitating factors and the occurrence of skeletal destruction. Cutaneous erythema without necrosis is understood to be incipient diabetic gangrene.

Adult↗
PubMed2004

A case of docetaxel-induced erythrodysesthesia.

Chemotherapy-induced acral erythema (CIAE) is a rare cutaneous reaction to high-dose chemotherapy, clinically featuring painful erythema on the palms and soles. Docetaxel (Taxotere), an anticancer agent, is known to cause various reactions, including CIAE. We experienced a case of docetaxel-induced acral erythema with facial edematous erythema that coincidentally emerged and regressed with appearance and disappearance of the acral lesions. Docetaxel-induced acral erythema exhibits a widespread distribution and intense sensations of intolerable pain and numbness. Therefore, some authors use the term erythrodysesthesia instead of acral erythema. We speculated that the facial erythema might be part of the spectrum of erythrodysesthesia. Our case was finally diagnosed as decetaxel-induced erythrodysesthesia. Although CIAE is self-limiting, the patients frequently require treatment because of intolerable pain. Reported treatments for CIAE include topical or systemic steroids, elevation of the legs, and application of cold compression to the lesion. In our case, application of a steroid ointment with the occlusive dressing technique (ODT) alleviated the clinical manifestations and was also prophylactic for the erythrodysesthesia.

Aged↗
PubMed1989

Thallium poisoning: a dermatological perspective.

The dermatological findings in five patients with thallium poisoning are described. Cutaneous involvement consisted mainly of an acneiform eruption, pellagra-like dyssebacea, crusted eczematous lesions and dry scaling of the distal parts of the extremities. Alopecia was not evident initially but later became apparent. The patients also had gastrointestinal and neurological symptoms and signs.

Alopecia↗
PubMed2004

Prevalence of foot diseases in outpatients attending the Institute of Dermatology, Bangkok, Thailand.

Two thousand patients who visited the outpatient department at the Institute of Dermatology, Bangkok, were assessed for the presence of foot diseases by questionnaire and physical examination. Abnormalities were detected in 741 individuals (37.1%). Nonfungal conditions were more prevalent (31.4%), mainly consisting of eczema (254 cases, 12.7%) and psoriasis (176 cases, 8.8%). Fungal disease was observed in 119 cases (6.0%). There were 76 cases (3.8%) with tinea pedis and 33 cases (1.7%) with onychomycosis. The identified organisms causing tinea pedis were 57.9% nondermatophyte moulds, 36.8% dermatophytes, and 2.6%Candida spp. The corresponding organisms causing onychomycosis were 51.6% nondermatophyte moulds, 36.3% dermatophytes, and 6.0%Candida spp. Among nondermatophytes, Scytalidium dimidiatum was the leading pathogen while Trichophyton rubrum and T. mentagrophytes were the predominant dermatophytes identified. Diabetes mellitus, peripheral vascular disease and activities related to foot trauma were noted to be predisposing factors for onychomycosis. Footwear, particularly sandals and cut shoes, was the only factor relevant to individuals with tinea pedis (P < or = 0.05). In contrast with other published data on fungal foot infections, this study disclosed a higher prevalence of nondermatophyte organisms, predominantly S. dimidiatum, as the major cause of tinea pedis and onychomycosis. An increase in awareness is necessary to identify such cases, prevent misdiagnosis and initiate appropriate treatment.

Adolescent↗
PubMed2006

Characterization of a spirochaete isolated from a case of bovine digital dermatitis.

AIMS: The aim of the study was to characterize a spirochaete isolated from the lesions of a cow with digital dermatitis (DD). METHODS AND RESULTS: The characterization was on the basis of its light and electron microscopic appearance, enzymic profile and DNA sequence analysis of its flagellin and 16S rRNA genes. The spirochaete was 6-8-microm long and 0.2-0.3 microm in diameter, and possessed seven to eight periplasmic flagella, with three to five helical turns. The enzymic profile of the bacterium resembles, but is not identical to that of Treponema brennaborense. Its flagellin gene sequence was identical to that of Treponema phagedenis but distinct from that of an ovine spirochaete. Analysis of a 1477-bp region of the 16S rRNA genes indicated that this is a Treponema species and that it is indistinguishable from some isolates made from cases of bovine DD in the United States. Finally, electron microscopy revealed the presence of myovirus-like bacteriophage particles in all cultures of the treponeme examined. CONCLUSIONS: The spirochaete isolate was identified as a Treponema species closely related to some isolates from the United States (by 16S rDNA) and to T. phagedenis (by flagellin gene sequence) and is associated with bacteriophage particles. SIGNIFICANCE AND IMPACT OF THE STUDY: The fact that the isolates with the same or very similar 16S rDNA sequences have been obtained from cases of bovine DD in cattle in different countries at different times, lends further support to the hypothesis that treponemes play a role in the pathogenesis of this disease.

Animals↗
PubMed1993

Effective detection of plantar malignant melanoma.

BACKGROUND: As the sole of the foot is the most prevalent site of malignant melanoma in non-Caucasians, early detection of the neoplasm at this anatomical site is very important. In our previous study, we proposed a clinical guideline that acquired melanocytic lesions on the sole larger than 7 mm in maximum diameter should be examined histologically. METHODS: Eighty-one Japanese patients with the complaint of plantar pigmented lesions were screened at our dermatology clinic during 3 years using the 7-mm criterion. RESULTS: Of the total 80 melanocytic lesions on the sole, 14 lesions were larger than 7 mm in maximum diameter, excluding congenital lesions. Diagnoses of the 14 "large" lesions were as follows: advanced malignant melanoma, 8 lesions; early malignant melanoma (malignant melanoma in situ), 1 lesion; acquired melanocytic nevus, 4 lesions, and volar melanotic macule, 1 lesion. CONCLUSIONS: The present study confirmed the validity of the 7-mm criterion for the early effective detection of plantar malignant melanoma.

Adolescent↗
PubMed2005

The effects of foot disease on quality of life: results of the Achilles Project.

BACKGROUND: Foot diseases have a high prevalence in the general population, but their impact on quality of life has not been assessed in large-scale studies. The Achilles Project surveyed foot disease in patients visiting their primary care physician or dermatologist. METHODS: A total of 43 593 patients were asked about the impact of their condition on their quality of life: pain, discomfort in walking, limitations in daily activities, and embarrassment. RESULTS: Overall, 52.5% of patients had some aspect of their quality of life affected by their foot disease. More specifically, 30.7% of patients experienced pain, 40.3% had discomfort in walking, 19.6% had their daily activities limited, and 27.3% were embarrassed. The survey indicated a larger impact of foot disease on the quality of life of women vs. men in all categories, except for daily activities. Similarly, the elderly (> or = 65 years) were more affected by their foot disease, although they suffered no more embarrassment than other age groups. Participation in sports seemed to lower the proportion of patients who had their quality of life adversely affected. Non-fungal foot diseases, particularly ulcer and gangrene, are more likely to cause pain, discomfort in walking and limit daily activities, than fungal diseases. CONCLUSIONS: In general, non-fungal foot diseases caused pain, discomfort in walking and limitations in daily activities in more patients than fungal foot diseases, but a higher proportion of patients with fungal foot diseases were embarrassed by their condition than patients with non-fungal foot diseases. The study found that the impact of foot disease on quality of life may be greater than previously suggested. Given that effective treatments are available, routine examination of patients' feet by dermatologists and primary care physicians may help to reduce the burden of these foot conditions.

Activities of Daily Living↗
PubMed1985

The bilobed flap in sole surgery.

The bilobed flap is a simple reconstructive technique principally used to correct substantial defects in the facial region. We present our experience with this local flap in the difficult plantar area, with excellent short-term functional results. We describe the special characteristics of the bilobed flap in this zone, and comment on its indications and possible complications.

Adult↗
PubMed1991

The prevalence and nature of podiatric problems in elderly diabetic patients.

To determine if diabetes in the elderly is associated with increased prevalence of podiatric problems, a random sample of diabetic patients (n = 74) was compared to a group of elderly non-diabetic patients (n = 79). The two groups were comparable in age (range 70-90 years), smoking habits, and consumption of alcohol. The mean duration of diabetes was 14.5 +/- 11.7 years (+/- SD), and mean serum fructosamine level was 3.3 +/- 0.66 mmol/L. The number of medical diagnoses and medications used was significantly higher in the diabetic group. Diabetic patients had modestly higher prevalence of neuropathy, vascular disease, kidney disease, and eye complications. The most common podiatric problem in both groups was elongated toenails. The prevalence of podiatric problems such as cellulitis, amputation, tinea pedia, onychomycosis, calluses, bunions, and hammer toe deformity were not increased in diabetic patients. Active foot ulcers were more common in diabetic patients (13/74 vs 5/79, P less than 0.05). It is concluded that diabetes in the elderly, unlike in young patients, increases the risk of foot problems only marginally.

Aged↗