[Onychomycoses caused by non-dermatophytic filamentous fungi in Cádiz]. / Onicomicosis por hongos filamentosos no dermatófitos en Cádiz.

BACKGROUND: The incidence and clinical significance of other than dermatophytes fungi or moulds causing onychomycosis is unknown, because they may be colonising organisms rather than pathogen. This report presents the results of a study conducted between 1997 and 1999 to determine the incidence and aetiology of onychomycosis by non-dermatophytic filamentous fungi in the population of Cádiz (Spain). PATIENTS AND METHODS: Diagnosis of onychomycosis was performed by direct microscopic examination, culture and, some times, by histologic examination, on samples from 610 patients with clinical suspected fungal nail infections. RESULTS: Among 196 (32%) cases of ungual mycosis detected, 29 (15%) of them were caused by non-dermatophytic filamentous fungi, presenting positive direct microscopy and repeated cultures. Superficial and distal onychomycosis were the most frequent clinical types. Twenty two patients had onychomycosis of toenails. The highest incidence was found in women and subjects over the age 40. Scopulariopsis spp. (n = 11), Aspergillus spp. (n = 6), Alternaria spp. (n = 5) and Fusarium spp. (n = 4) were the most common fungi. Occasionally, Acremonium spp. and Scedosporium spp. were isolated. CONCLUSION: The incidence of onychomycosis caused by opportunistic fungi is not well known. For their diagnosis, it is important to select correctly the appropriate site for specimen collection, as well as direct microscopy and fungal cultures. The incidence of onychomycosis is high in Cádiz (Spain), being higher in women and older people. Predispondent factors are not always identified in the patients. Toenails were infected more than fingernails in both sexes. The results of our study suggest that Scopulariopsis spp. is an important agent of onychomycosis. Epidemiological investigations should be performed in every country in order to determine the fungal species responsible of onychomycosis.

[X-ray microanalysis of epitheliomas and melanomas: is the Cu/Zn index a prognostic parameter? Preliminary note]. / Microanálisis de rayos X en epiteliomas y melanomas: es el índice Cu/Zn un parámetro pronóstico? Nota previa.

The authors comment the interest of the X Ray microanalysis in Dermatology and, especially, the Cu/Zn index determination in cutaneous tumors.

[Adquired epidermolysis bullosa. Immunopathological and ultrastructural studies]. / Epidermólisis ampollosa adquirida. Estudio inmunopatológico y ultraestructural.

A case of epidermolysis bullosa acquisita (EBA) in a 64 year old man is reported. The direct immunofluorescence showed a positive lineal anti IgG basement membrane on the affected skin (blisters and provocation tests) and on the univolved healthy skin. The electron microscopic studies showed a "dermolysis". In this patient it was not possible to find any pathological association. The EBA is usually associated with different processus but, sometimes, it could be isolated. Probably this clinicopathological field includes diverse badly delimited entities.

Scanning electron microscopic and X ray microanalysis study of the mineral deposits in pseudoxanthoma elasticum.

A skin biopsy of a 37 year old man with typical lesions of pseudoxanthoma elasticum (P.E.) associated with angioid streaks (Groenbald-Strandberg Syndrom) was examined with a scanning E.M. (SEM) and a SEM provided with a X ray micro-analyser. The SEM provided with X ray microanalyser enabled us to see the correspondence between the crystalline deposits and a calcium salt. The potassium, sodium and magnesium analysis of the specimen permits us to verify that the P.E. dermis is rich in K and poor in Mg.

[Groenblad-Strandberg syndrome. Study with scanning microscopy provided with an X rays analyzer]. / Sindrome de Groenblad-Strandberg. Estudio al microscopio de "scanning" provisto de analizador de rayos X.

A skin biopsy a 37 year old man with typical lesion of pseudoxanthoma elasticum associated with angioid striae (Groenblad-Strandberg syndrome) was examined with a scanning EM (SSM-2A) and a scanning EM provided with a X ray microanalyser. With the scanning EM (SSM-SA) it was possible to see tabular crystalline deposits with subround faces and rhombohedric tendency. The scanning EM provided with a X ray microanaliser enabled us to see crystalline deposits which in some fields adopt a star-shaped form corresponding to calcium crystals of not very well defined habit. The X ray microanalyser shows us the correspondence between the star shaped figures and a calcium salt. The potassium, sodium and magnesium analysis of the specimen permits us to verify that the pseudoxanthoma elasticum dermis is rich in K and poor in Mg.