1/5. erythema nodosum in patients with tinea pedis and onychomycosis.To document association between erythema nodosum and concomitant fungus infection, we studied seven white women seen during a six-year period in our office practice. Five patients are presented. Unilateral erythema nodosum occurred in three patients on the same side as unilateral tinea. Tests with potassium hydroxide (KOH), cultures of nodules on Sabouraud agar and dermatophyte test medium (DTM), skin biopsy, and clinical examination ruled out nodular granulomatous perifolliculitis of Wilson. Lesions simulating erythema nodosum were produced when trichophyton antigen was injected subcutaneously in the lower legs. All nodose and fungal lesions cleared after griseofulvin therapy. Fungus infection of feet or nails should be considered a possible cause of erythema nodosum when no other cause is apparent.- - - - - - - - - - ranking = 1keywords = nail (Clic here for more details about this article) |
2/5. trichophyton rubrum in the external auditory meatus.We report the case of a 28-year-old immunocompetent male suffering from otitis externa. The right external auditory meatus was filled with cerumen and detritus, the tympanic membrane covered wallpaper-like with layers of fungi. Mycological analysis revealed trichophyton rubrum. With further examination tinea pedis of plantar and interdigital type and concomitant onychomycosis of the toenails due to T. rubrum could be detected. The auditory meatus was cleaned and treated topically with clotrimazole. Two weeks later the auditory meatus and the tympanic membrane were bare of fungi and the inflammation was resolved. Treatment of tinea pedis and onychomycosis with terbinafine (systemically and topically) is still lasting.- - - - - - - - - - ranking = 1keywords = nail (Clic here for more details about this article) |
3/5. tinea pedis masking a Kaposi's sarcoma.A 67-year-old white man presented with bilateral blancing erythema and scale of the second through fifth toes extending on to the dorsa and moccasin areas of the feet for two years. The right great toe had subungual debris. No cultures or KOH studies were recorded. A course of tolnaftate cream therapy was initiated. Two years later, the patient returned and complained of no change in his condition. Previously recorded descriptions and diagrams in the medical record confirmed his report. At this time, KOH preparations from the skin and nail were positive for hyphae. He refused to accept medical recommendations for a fungal culture and griseofulvin therapy. He, therefore, was instructed to use miconazole cream twice daily as alternative treatment. One year later, physical examination was unchanged. KOH preparations and fungal cultures of the skin were twice negative. A 4-mm punch skin biopsy specimen of the erythematous patch on the dorsum of the foot was performed. hematoxylin and eosin-stained sections revealed a proliferating vascular process in the cutis. Many spindle-shaped cells formed vascular slits and endothelial-lined spaces in which there were erythrocytes. No hyphae were seen. One year after the biopsy specimen was taken, the erythema of his feet persists, and a few nonblanching nodules are visible. He declined further studies.- - - - - - - - - - ranking = 1keywords = nail (Clic here for more details about this article) |
4/5. Treatment of onychomycosis and tinea pedis with intermittent itraconazole therapy.A 40-year-old woman had a 10-year history of dermatophyte-related toenail onychomycosis (tinea unguium) and dry-type tinea pedis, which had failed to respond to previous therapy with topical antifungal agents or oral griseofulvin. The patient was successfully treated with four cycles of intermittent itraconazole therapy (that is, 400 mg/d for 1 week per month for 4 months). At the end of this time, the tinea pedis had resolved and the onychomycosis improved significantly after four cycles were completed. Twelve months after the onset of therapy, both conditions had resolved completely according to both clinical and mycologic criteria. itraconazole was well tolerated, with no side effects reported. These observations suggest that itraconazole intermittent dosing is a highly effective therapy for the treatment of onychomycosis caused by dermatophyte organisms, because it provides a high cure rate after only a short course of therapy.- - - - - - - - - - ranking = 1keywords = nail (Clic here for more details about this article) |
5/5. Long-term remission of two feet-one hand syndrome.Two feet-one hand syndrome is also defined as bilateral plantar tinea pedis with coexistent unilateral tinea manuum. Toenails and fingernails may also be affected and the dermatophyte trichophyton rubrum is the usual cause. When there is nail involvement, especially of the toenails, treatment with an oral antifungal agent should be considered because topical therapy alone is usually not effective. However, relapses are common. With the advent of new, more effective antifungal drugs such as itraconazole, terbinafine, and fluconazole, it is hoped that this troublesome and recalcitrant disorder may be better controlled.- - - - - - - - - - ranking = 4keywords = nail (Clic here for more details about this article) |