[Epidemiologic appearance of molluscum contagiosum in a rare form and localization].
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INTRODUCTION: The microbiological identification of onychomycosis may be uncertain as some fungi growing in culture from this material are not necessarily pathogen and invasive. Conversely, the negativity of a culture is not rare even when fungi are seen by microscopy. MATERIALS AND METHODS: We compared the information brought by standard histological examination, immunohistochemistry and in vivo confocal microscopy. RESULTS: The histological examination of nails is of importance in this pathology. We present a laboratory technique that proves to be easy and rapid. We report diagnostic criteria allowing the distinction between dermatophytes, yeasts and non-dermatophyte molds. The standard microscopic examination may further be improved by immunohistochemistry using some antibodies to fungi. In vivo confocal microscopy is a technique for the future. The dermatologist will be able to see fungi in the nail at the clinical examination, without any sampling or peculiar preparation. CONCLUSION: The histological examination is a routine technique useful for defining the nature and localization of fungi in the nail plate. Immunohistochemistry applied to onychomycosis is an experimental approach bringing prominent informations about the identification of fungi. In vivo confocal microscopy is a door opened to the future.
Dyshydrosiform bullous pemphigoid is a clinical variant of bullous pemphigoid in which the lesions appear primarily on palms and soles. Knowledge of this unusual manifestation of bullous pemphigoid may be of practical relevance, since it has to be included in the differential diagnosis of blistering palmoplantar dermatoses. The correct diagnosis is confirmed by histological examination and immunofluorescence, which reveal all the characteristic hallmarks of bullous pemphigoid. Three patients with dyshydrosiform bullous pemphigoid are presented; clinical and histological aspects, findings on immunofluorescence, differential diagnosis and therapy are discussed.
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The phagocytic bactericidal capacity of circulating neutrophilic granulocytes was estimated in 22 patients with pustulosis palmoplantaris (PPP). The control group comprised 100 healthy individuals. Leukocytes from the patients had a statistically significant reduced capacity to kill Staph. aureus in autologous as well as in AB serum. Leukocyte killing of E. coli was not reduced. Serum levels of total hemolytic complement, C3, C4 and neutrophil myeloperoxidase activity were normal. The findings suggest an intrinsic or cellular defect of circulating neutrophil granulocytes in patients with PPP.
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Eccrine poromatosis (EP) of remarkable severity has been observed in a patient with hidrotic ectodermal dysplasia (HED), a member of the kindred originally described by Clouston. Neither the EP nor its association with HED has been previously reported.
Three patients had secondary syphilis with severely pruritic skin lesions. This presentation contradicts several modern medical texts in which the lesions of secondary syphilis are described as nonpruitic.
Contact dermatitis caused by surgical gloves is well known. Contact urticaria and anaphylactoid reactions among hospital personnel and patients following contact with latex gloves and glove dusting powder have previously been reported. A suspected increased frequency of hand eczema among personnel using detergents and surgical gloves in operating units initiated the present study. A questionnaire survey was performed in order to examine the frequency and degree of hand eczema among 332 surgeons and nurses working at the surgical units of Odense University Hospital during the period 1.6.-1.9.1989. A total of 242 persons (72%) answered the questionnaire. One hundred and fourteen persons (47%) claimed to develop skin discomfort or hand eczema following the washing procedure or use of surgical gloves. Among the personnel with skin problems 60% had spontaneously changed to another detergent/glove-product with subsequent clearing of the symptoms in 75% of the cases. Dermatological examination and patch tests were performed with European Standard series, gloves, rubber chemicals and selected soap components in 53 persons. Hand eczema was found in 16 persons (7%). Positive patch test reactions to latex gloves were found in four persons and only one person reacted to the rubber accelerators known to be present in the gloves according to the manufacturers' information. Among 26 persons with skin-discomfort and immediate symptoms, ten were prick tested with the standard battery of inhalant allergens, corn starch surgical glove powder, and extract of surgical gloves. Three persons reacted to glove extract, none reacted to glove powder.(ABSTRACT TRUNCATED AT 250 WORDS)
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Nineteen patients with chronic, recalcitrant palmoplantar pustulosis took either placebo or aromatic retinoid ethyl ester (Ro 10-9359) during a 4-month therapeutic trial. The maximal dose of Ro 10-9359 varied between 25 and 100 mg per day, according to the individual patient's tolerance. An excellent or good therapeutic response was obtained in 6 out of 9 patients on the active medication and in 2 out of 10 patients on placebo. The difference in therapeutic response between the Ro 10-9359 group and the placebo group was statistically significant (p less than 0.05). Drying and chapping of the lips was the most common side effect of Ro 10-9359 treatment.
INTRODUCTION: Skin lesions may occur in approximately 30 p. 100 of cases of carbon monoxide poisoning. Flushes, erythematous to violaceous blisters on pressure zones due to sweat gland necrosis can be observed in such case. CASE REPORT: We report a case of acral (fingers, ears and nose) superficial cutaneous necrosis due to carbon monoxide poisoning. DISCUSSION: Such a complication had never been reported as a cutaneous manifestation of acute carbon monoxide intoxication. Also rare, acral necrotic lesions in a comatose or obnubilated patient should suggest this diagnosis.
Lichen planus and lupus erythematosus may occur as an overlap syndrome. Here we report the clinical characteristics of a 49-year-old man with palmoplantar lichen planus and lupus erythematosus. He showed a remarkable clinical response to treatment with acitretin, which resulted in prolonged remission of the disorder.
A report on two cases is given. The patients showed the typical skin affections after trips to Africa. Tungiasis occasionally leads to secondary infections and may be the cause of longterm inflammation or erysipelas. Treatment is discussed and a possible increase of tungiasis because of an increase of tourists to tropical countries is pointed out.