We present a case of dermatophytic granuloma caused by Microsporum canis in a heart-lung recipient. This 66-year-old man was seen for erythematous pustules and papules on the forearm. The diagnosis was suspected after histological examination showing an inflammatory infiltrate in the upper dermis with giant cells containing intracytoplasmic fungal elements. Cultures of the skin biopsy confirmed the diagnosis identifying M. canis. Our case emphasizes the possibility of deep dermatophytic infections in immunocompromised patients. There are only 4 additional reports of M. canis infection responsible for invasion of the dermis in such patients. The follicle involvement probably explains these dermal lesions due to the progression of the dermatophyte from the hair follicle to the dermis. In our observation topical antifungal therapy alone was unsuccessful and fluconazole seems to be the treatment of choice for these M. canis invasive dermal cutaneous infections.

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In order to characterize the abnormalities of bone remodelling in the various stages of plasma cell disorders, we studied 60 patients (29 monoclonal gammopathies of uncertain significance (MGUS), 13 stage I myeloma, 18 stage III myeloma). We carried out histomorphometric study of bone biopsies in 34 patients and measurement of osteocalcin and the calciuria/creatinine ratio. Bone remodelling was approximately normal (BV/TV:21.2 +/- 7, ES:4.1 +/- 2, OS:16.5 +/- 10) in MGUS. Stage I myeloma was characterised by parallel increases in resorption surfaces and osteoid surfaces (BV/TV:18 +/- 5, ES/BS:7.4 +/- 3.5, OS/BS:24.8 +/- 11.5), of the ca/cr ratio and osteocalcin. In stage III myeloma, resorption surfaces and the ca/cr ratio showed an even greater increase while osteoid surfaces, osteocalcin and trabecular bone volume decreased (BV/TV 13.6 +/- 6, ES/BS:12.1 +/- 6, OS/BS:13.6 +/- 8.3). Osteocalcin and osteoid surfaces were correlated (r = 0.5). There was a positive correlation between osteocalcin and the number of plasmocytes in stage 1 myeloma (r = 0.64) and a negative correlation in stage III myeloma (r = 0.9). Bone remodeling was normal in MGUS; bone remodelling grew with a parallel increase of formation and resorption in stage I; bone resorption increased while bone formation decreased in stage III myeloma.

Objectives-To determine whether the Epstein-Barr virus is present in synovial membranes and subcutaneous nodules of patients with rheumatoid arthritis. Methods-A sensitive in situ hybridisation technique was applied to tissue sections of 11 synovial membranes and five rheumatoid nodules. Results-Cells carrying the Epstein-Barr virus were not detected using EBER and BHLF1 oligonucleotides in the tissue samples investigated here. Conclusions-Although it has been suggested that the Epstein-Barr virus could play a part in the aetiology of rheumatoid arthritis, it was not detected in synovial membranes and subcutaneous lesions in this study.