Cutaneous mucormycosis as a presenting feature of type 1 diabetes in a boy - case report and review of the literature.

BACKGROUND: Mucormycosis is a potentially fatal complication of diabetes. The rhino-orbito-cerebral form is the most common presentation, however, rarely other types can also be seen. CASE PRESENTATION: We describe the case of a 4½ -year-old boy not previously known to be a diabetic who presented to the plastic surgery department for gangrene of the left middle finger with surrounding erythema and induration. After the diagnosis of diabetes and initial treatment, pus from the wound showed broad aseptate hyphae suggestive of mucormycosis which was further confirmed on culture. Aggressive surgical debridement including amputation, antifungal treatment and glycemic control achieved a complete cure. CONCLUSIONS: Cutaneous mucormycosis is a rare complication of type 1 diabetes mellitus and can even be seen at the onset of diabetes. High index of suspicion, timely antifungal treatment and aggressive surgical debridement usually lead to recovery in the localized form of the disease.

Claw-finger correction in leprosy using half of the flexor digitorum superficialis.

The commonest paralytic deformity in leprosy is the claw deformity of the fingers. Many surgical procedures have been described and are practiced to correct this deformity, but none is free from complications. A modification of the Zancolli lasso operation in which only half of the flexor digitorum superficialis tendon of the middle finger was used as the motor is described and a comparative study of this and the conventional procedure was carried out in 70 hands in 70 patients. The results suggest that the modification is technically simpler, with comparable results to those of the conventional procedure and fewer complications.

Mycobacterium marinum causing tenosynovitis. 'Fish tank finger'.

Mycobacterium marinum is an unusual atypical mycobacterium with low pathogenicity for humans in comparison with Mycobacterium tuberculosis. Among the non-tuberculous mycobacterial pathogens, Mycobacterium marinum is the most common pathogen to cause skin infections. Mycobacterium marinum infection causes chronic cutaneous lesions and in some cases deeper infections such as tenosynovitis, septic arthritis and rarely osteomyelitis. We report the case of a male patient presenting with tenosynovitis of the distal upper extremity secondary to Mycobacterium marinum infection.

Subcutaneous and osteolytic rhinosporidiosis.

A young man presented with multiple Subcutaneous nodules over scalp, hand, feet and osteolytic lesions of small bones of hand. Clinically and radiologically he was diagnosed as a case of Giant Cell Tumour. Aspiration cytology and biopsy proved it to be rhinosporidiosis. Epidemiological study revealed that he perhaps contracted this infection as an occupational hazard. This is the third reported case of osteolytic lesions due to rhinosporidiosis. Diagnostic dilemmas of subcutaneous and osteolytic rhinosporidiosis are discussed.

Symmetrical deforming cutaneous sporotrichosis of long duration.

A symmetrical deforming cutaneous sporotrichosis with verrucous lesions on both hands and of long clinical duration is reported. The difficulties in making an etiological diagnosis are considered.

[New technic of palliative intervention in paralysis of the intrinsic muscles of the hand (cubital paralysis in Hansen's disease)]. / Nouvelle technique d'intervention palliative dans la paralysie des muscles intrinsèques de la main (paralysie cubitale dans la maladie de Hansen).

On a single poster, drawings explain a surgical technique we performed for some time in the Institut Marchoux on souple clawed fingers in hansenian ulnar palsy. Sketches at first recall anatomy physiopathogeny's principles and hence usual operations yet performed, then the main steps of our method. Its qualities are simplicity, speediness and compatibility with other treatments. In spite of being too recent for a proper view, results are already hopeful.