Pitted keratolysis.

Pitted keratolysis is a skin disorder that affects the stratum corneum of the plantar surface and is caused by Gram-positive bacteria. A 30-year-old male presented with small punched-out lesions on the plantar surface. A superficial shaving was carried out for scanning electron microscopy. Hypokeratosis was noted on the plantar skin and in the acrosyringium, where the normal elimination of corneocytes was not seen. At higher magnification (x 3,500) bacteria were easily found on the surface and the described transversal bacterial septation was observed.

Pitted keratolysis

Abstract Pitted keratolysis is a skin disorder that affects the stratum corneum of the plantar surface and is caused by Gram-positive bacteria. A 30-year-old male presented with small punched-out lesions on the plantar surface. A superficial shaving was carried out for scanning electron microscopy. Hypokeratosis was noted on the plantar skin and in the acrosyringium, where the normal elimination of corneocytes was not seen. At higher magnification (x 3,500) bacteria were easily found on the surface and the described transversal bacterial septation was observed.

Detection of Borrelia burgdorferi sensu stricto and Borrelia garinii DNAs in patient with Hyperkeratosis lenticularis perstans (Flegel disease).

Determination of the causative agent of erythema-like skin lesions in case of nonspecific superficial perivascular dermatitis was supported by histological examination and led to the latter diagnosis of Hyperkeratosis lenticularis perstans (Flegel disease) in patient. The presence of antibodies against Borrelia burgdorferi in patient serum was confirmed by a routine ELISA method and verified by Western blot technique. Skin biopsy and blood specimens were analyzed by PCR and multilocus sequence analysis (MLSA). Western blot method revealed IgG antibody response against two specific antigens, 17 and 83 kDa proteins. The recombinant test detected IgG antibody response against p100 and p41 antigens. The sequence analysis of amplicons from the selected genomic loci obtained from skin biopsy and serum samples revealed the presence of two species from B. burgdorferi sensu lato complex as a co-infection in this patient-B. burgdorferi sensu stricto (s.s.) and Borrelia garinii.

Diagnosis using the nail bed and hyponychium.

"Nails protect the fingertips and toes. Diseases affecting the nail can cause cosmetic disfigurement and social embarrassment. Physical functioning may be impaired. Disorders of the nail bed may cause pain or create difficulty grasping fine objects. The nail bed is the area beneath the nail plate between the lunula and the hyponychium. Disorders of the nail bed can cause onycholysis, subungual hyperkeratosis, and/or onychogryphosis. Ventral pterygium is less common. Tumors of the nail bed are rare and commonly missed."

Generalized hyperkeratosis caused by Scopulariopsis brevicaulis in a Japanese Black calf.

A 6-month-old Japanese Black female calf became gradually emaciated over a 40-day period and was humanely killed. At necropsy, hyperkeratotic nodules were seen to have spread over almost the entire body surface. Scopulariopsis brevicaulis was isolated from the skin and identified morphologically and by gene sequence analysis of the D1/D2 domain of large subunit ribosomal RNA. Numerous periodic acid-Schiff-positive, lemon-shaped conidia were detected histologically in the keratinized layer and the hair follicles. The distribution of the fungal elements in the skin corresponded to that of the hyperkeratotic lesions. This is the first report of a disease caused by S. brevicaulis in animals. Previously reported human infections have not included generalized hyperkeratosis.

Natamycin treatment of experimental Candida albicans induced keratomycosis in rabbits

Objective: The efficacy of topical natamycin 5% was studied using a reproducible model of keratomycosisproduced by Candida albicans in the rabbits. Method: Candida albicans was isolated from infected human eye and 4 x 105 cells of the Candida albicans was injected into the corneal stroma of the eyes of 15 rabbits. All eyes developed a corneal ulcer without pretreatment with immunosuppressive agents. Forty-eight hours after inoculation, the animals were divided into two groups: test group I, 10 eyes receiving natamycin drops in a 5% suspension; control group II, five eyes receiving 0.9% normal saline solution. The rabbits¡¯ corneas were removed for Candida albicans recovery and placed in 1 ml of sterile 0.9% normal saline solution, minced within two hours with scalpel and thoroughly homogenized with a piston and mortar. Serial dilutions of this corneal solution from 10-1 ¨C 10-4 were made in 0.9% sterile saline solution and 100 ¦Ìlaliquots were plated onto tryptic soy agar. All cultures of cornea from the treated eyes were negative after seven days of inoculation while five cultures were still positive in the control eyes at the end of the experiment. Result: It was found that 5% natamycin was effective in treating experimental Candida albicans induced keratomycosis in rabbits. Conclusion: It is concluded that natamycin has a significant effect (p < 0.01) against Candida albicansin treating experimental keratomycosis.

Objetivo: La eficacia de la natamicina tópica al 5% fue estudiada usando un modelo reproducible de queratomicosis producida por Candida albicans en conejos. Método: Candida albicans fue aislada de una infección ocular humana y 4 x 105 células de Candida albicans fueron inyectadas en el estroma córneo de los ojos de 15 conejos. Todos los ojos desarrollaron una úlcera córnea sin pre-tratamiento con agentes inmunosupresores. Cuarenta y ocho horas después de la inoculación, los animales fueron divididos en dos grupos: un grupo experimental I, en el que diez (10) ojos recibieron gotas de natamicina en suspensión al 5%; y un grupo control II, en el que cinco(5) ojos recibieron solución salina normal al 0.9%. Las córneas de los conejos fueron extraídas para recuperar Candida albicans y colocadas en 1 ml de solución salina normal estéril, para ser luego desmenuzadas a las dos horas con un escalpelo, y homogeneizadas completamente con un mortero. Sehicieron diluciones seriadas de esta solución córnea de 10-10 -10-4 en solución salina al 0.9% y 100 mlde alícuotas fueron colocadas en placas con agar de soya tríptico. Todos los cultivos de corneas de los ojos tratados, resultaron negativos luego de siete días de inoculación, mientras que 5 cultivos eran todavía positivos al final del experimento en los ojos del control.Resultado: Se halló que la natamicina al 5% era efectiva en el tratamiento de la queratomicosis inducida experimentalmente mediante Candida albicans en conejos. Conclusión: Se concluyó que la natamicina surte efecto (p < 0.01) sobre Candida albicans en eltratamiento experimental de la queratomicosis.

Abnormal keratin expression in circumscribed palmar hypokeratosis.

BACKGROUND: Circumscribed palmar or plantar hypokeratosis (CPH) is a rare skin disorder only recently described. OBJECTIVE: To determine the diagnostic features and to provide insight into the pathogenesis of CPH, with analysis of two new Japanese cases. METHODS: Dermoscopy, immunohistochemistry, electron microscopy, polymerase chain reaction amplification for human papillomavirus (HPV) DNA and 16S microbial rRNA gene profiling were conducted. RESULTS: Dermoscopy showed characteristic features using both dry and jelly immersion observation; step-like desquamation and a homogeneous erythema with regularly distributed whitish spots. Immunohistochemistry revealed strong staining with anti-pankeratin antibody (AE1+AE3) and anti-keratin 16 antibody, and decreased expression of keratin 2e. EM revealed a breakage of the corneocytes within their cytoplasm, but structures for cell attachment were intact. HPV and lesion-specific bacteria were not detected. LIMITATIONS: The number of cases analyzed was two. CONCLUSION: Hyperproliferative epidermal state along with enhanced corneocyte fragility may account for the unique features in CPH.

Natamycin treatment of experimental Candida albicans induced keratomycosis in rabbits.

OBJECTIVE: The efficacy of topical natamycin 5% was studied using a reproducible model of keratomycosis produced by Candida albicans in the rabbits. METHOD: Candida albicans was isolated from infected human eye and 4 x 10(5) cells of the Candida albicans was injected into the corneal stroma of the eyes of 15 rabbits. All eyes developed a corneal ulcer without pretreatment with immunosuppressive agents. Forty-eight hours after inoculation, the animals were divided into two groups: test group I, 10 eyes receiving notamycin drops in a 5% suspension; control group II, five eyes receiving 0.9% normal saline solution. The rabbits' corneas were removed for Candida albicans recovery and placed in 1 ml of sterile 0.9% normal saline solution, minced within two hours with scalpel and thoroughly homogenized with a piston and mortar Serial dilutions of this corneal solution from 10(-1) - 10(-4) were made in 0.9% sterile saline solution and 100 microl aliquots were plated onto tryptic soy agar. All cultures of cornea from the treated eyes were negative after seven days of inoculation while five cultures were still positive in the control eyes at the end of the experiment. RESULT: It was found that 5% natamycin was effective in treating experimental Candida albicans induced keratomycosis in rabbits. CONCLUSION: It is concluded that natamycin has a significant effect (p < 0.01) against Candida albicans in treating experimental keratomycosis.

Tuberculosis verrucosa cutis presenting as an annular hyperkeratotic plaque.

GOAL: To understand cutaneous tuberculosis to better manage patients with the condition OBJECTIVES: Upon completion of this activity, dermatologists and general practitioners should be able to: 1. Recognize the morphologic features of cutaneous tuberculosis. 2. Describe the histopathologic characteristics of cutaneous tuberculosis. 3. Explain the treatment options for cutaneous tuberculosis.