1/16. Lymphocutaneous sporotrichosis: a case report and unconventional source of infection.A 32-year-old white man had a 5-month history of a progressively worsening rash on the dorsal aspect of his left foot. He stated that he engaged in self-tattooing of the left foot prior to the onset of the rash. Further questioning revealed that he had mowed the lawn wearing only sandals on the same day that he had tattooed his foot. The rash was diagnosed as lymphocutaneous sporotrichosis based on clinical appearance, biopsy examination, and fungal culture. Clearing of the lesions was documented following 4 months of therapy with itraconazole. The remaining granulomatous lesions were flattened with intralesional corticosteroid injections.- - - - - - - - - - ranking = 1keywords = white (Clic here for more details about this article) |
2/16. White grain mycetoma caused by a Cylindrocarpon sp. in india.We describe a case of white grain eumycetoma of the foot of an Indian male caused by a slow-growing, poorly sporulating fungus that does not match any known agent of this infection. Histologic examination of a biopsy tissue specimen showed oval, lobular, white granules composed of hyaline, septate hyphae, and thick-walled chlamydospores. culture of granules from a draining sinus yielded compact, very-slow-growing, poorly sporulating colonies producing a strong reddish brown pigment that diffused into the medium. The fungus was identified as a Cylindrocarpon sp. based on the development of rare cylindrical conidia borne from solitary phialides lacking collarettes, in addition to chlamydospores formed singly or in short chains.- - - - - - - - - - ranking = 2keywords = white (Clic here for more details about this article) |
3/16. Volar melanotic macules in a Japanese man with histopathological postinflammatory pigmentation: the volar counterpart of mucosal melanotic macules.BACKGROUND: Volar melanotic macules are asymptomatic light-brown or tannish-grey macules usually found on the palms and/or soles of blacks, although they have also been reported on the volar surfaces of whites. Similar lesions have not been reported before in Japanese people. Since the cause is as yet unknown, it remains to be discussed whether they are a distinct entity. methods: In this report, a 52-year-old Japanese man with volar melanotic macules is reported with the clinical and histopathological findings. RESULTS: A 52-year-old Japanese man presented with many light-brown macules on his bilateral soles. He had a 20-year history of tinea pedis. Histopathological examination revealed melanophages and inflammatory infiltrates in the superficial dermis. There was a slight increase in melanin granules around the acrosyringium. Fontana-Masson stain revealed a slight increase in melanin granules in the basal layer including the acrosyringium and superficial dermis. These changes corresponded with postinflammatory pigmentation. CONCLUSIONS: This is the first report of volar melanotic macules in Japanese people. We suggest that volar melanotic macules is not an independent entity but a clinicopathological one that includes postinflammatory pigmentation, and that the condition is the volar counterpart of mucosal melanotic macules.- - - - - - - - - - ranking = 1keywords = white (Clic here for more details about this article) |
4/16. nocardia brasiliensis infection seen on grafted skin of the dorsum of a foot.For the past 4 years a 23 y-old female has noticed erythema on the dorsum of the right foot, where skin was grafted due to a traffic accident 20 years ago. She visited the Department of dermatology of Gifu Prefectural Hospital on Oct. 19, 1998; her general health was good. physical examination disclosed a swelling with erythema, papules and pustules on the dorsum of the right foot. The results of routine laboratory investigations were within normal limits except for the white blood cell count (11,300/mm(3)), blood sediment rate (25 mm/hrs), C reactive protein (1.21) and rheumatoid factor (x 16.6). Several yellowish and verrucous or wrinkled colonies were grown on Sabourauds agar culture from the biopsied specimen of the foot. Histopathological features showed epidermal hyperplasia with elongation of rete ridges and granulomatous changes in the dermis; many mononuclear and giant cells were present, and several positive fine filamentous and irregularly branching structures with PAS and Grocott stains were seen in the granulomatous nests. Both clinical and histopathological features led to speculation of nocardia infection, and nocardia brasiliensis was determined. The patient was treated by surgical total resection including the grafted skin. Although a soybean-sized nodule was seen on the border of the skin-graft of the foot three months later, there was no recurrence after the local resection.- - - - - - - - - - ranking = 1keywords = white (Clic here for more details about this article) |
5/16. Onychogryphosis in elderly persons: an indicator of long-standing poor nursing care? Report of one case and review of the literature.A 92-year-old immobilized white woman under the daily nursing care of a private ambulatory nursing service displayed acquired deformities of the toenails resembling a ram's horn. In light of a rapidly growing elderly population, this case report illustrates the need for close monitoring of the quality of care that nursing services provide to older persons. In addition, it reviews the clinical aspects of onychogryphosis, as well as its pathomechanisms and treatment options.- - - - - - - - - - ranking = 1keywords = white (Clic here for more details about this article) |
6/16. Arachnomyces kanei (anamorph Onychocola kanei) sp. nov., from human nails.Five isolates of a slow-growing cycloheximide resistant hyphomycetous fungus were obtained from nail specimens and investigated for their relationship to Onychocola canadensis (teleomorph Arachnomyces nodosetosus), a known agent of onychomycosis. In one patient diagnosed with superficial white onychomycosis, etiology was confirmed by a nail sample showing atypical filaments in direct microscopy, and by a follow-up specimen yielding cultures of the same fungus. A case of mixed infection with aspergillus sydowii was also confirmed after examination of cultures grown from three successive microscopic-positive hallux nail specimens. For other isolates, etiological significance could not be confirmed by repeat sampling or results of direct microscopy were negative or unknown. Mating experiments yielded setose ascomata containing smooth oblate ascospores typical of Arachnomyces species. Phylogenetic analysis of ITS 2 region sequences support the conspecificity of the isolates and their placement within the genus. A. kanei sp. nov. (anamorph O. kanei sp. nov.) is described.- - - - - - - - - - ranking = 1keywords = white (Clic here for more details about this article) |
7/16. Palmoplantar lichen planus presenting with vesicle-like papules.Palmoplantar lichen planus is a rare, localized variant of the disease that may create difficulty in diagnosis if it is present as an isolated finding. Although several morphological patterns may be seen, plaques or small papules with compact hyperkeratosis are usually observed. We present a 25-year-old woman with a one-month history of slightly pruritic, red papules on her palms and soles. Dermatologic examination revealed numerous, asymptomatic, unscaly, red papules on her palms and soles, some of them resembling vesicles and white reticulate plaques on both sides of the buccal mucosa. The diagnosis was established by the typical histopathological features of lichen planus. Although resistant to topical corticosteroids, she responded well to systemic corticosteroid therapy, and no recurrence was observed during the follow-up period of one year.- - - - - - - - - - ranking = 1keywords = white (Clic here for more details about this article) |
8/16. A case of adult T cell leukemia with bullae in the palmoplantar regions followed by a crisis.A 48-year-old Japanese female who had had chronic ATL for 4 years suddenly developed vesicles on the palms and soles. Histologically, these bullae were specific lesions of ATL. After a tendency toward improvement, a crisis appeared with increases in the following: peripheral white blood cells, atypical lymphocytes, CD25 positive cells, serum LDH, and soluble IL-2R. Palmoplantar bullae, a rather rare finding, may be indicative of a following crisis.- - - - - - - - - - ranking = 1keywords = white (Clic here for more details about this article) |
9/16. Superficial white onychomycosis revisited.BACKGROUND: Superficial white onychomycosis (SWO) is a distinct pattern of fungal nail invasion, which is usually treated with topical antifungals. OBJECTIVE: This paper presents a case of SWO with deep penetration and records other similar cases. methods: The clues to deep invasion of the nail plate are twofold: an inability to clear the discoloration by scraping the nail and a clinical involvement of the nail plate in the proximal nailfold area. histology of the nail keratin will confirm deep penetration beyond the superficial layers of the nail plate. RESULTS: In the light of this finding the authors propose a further subdivision of SWO to reflect previously unrecognized variants with therapeutic implications into: (i) the classical SWO type; (ii) the dual invasion of the nail plate, superficial and ventral; and (iii) the pseudo-SWO with deep fungal invasion of the nail plate. CONCLUSIONS: This subdivision of SWO allows the clinician to treat the patient appropriately using topical antifungals when the disease is restricted to the dorsum of the nail. Systemic drugs either in isolation or in combination with topical treatment are mandatory when deep penetration or ventral fungal invasion are observed.- - - - - - - - - - ranking = 5keywords = white (Clic here for more details about this article) |
10/16. Pustulotic arthroosteitis.We describe the case of a white male with chronic inflammation of one knee, the sternoclavicular area and the dorsal spine, who also had pustulosis palmaris et plantaris. Radiological changes were suggestive of pustulotic arthroosteitis. Our patient had prominent peripheral joint changes not previously emphasized.- - - - - - - - - - ranking = 1keywords = white (Clic here for more details about this article) |
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