Scanning electron microscopy of scutular tinea

Abstract

specimen revealed normal thickness of epidermis, subepidermal vesiculation, mild-to-moderate basal layer hyperpigmentation, basal cell degeneration, a few RBC extravasation, and many melanophages and telangiectasia on the papillary dermis ( Fig. 2a,b). However, neither subcutaneous fat necrosis nor dyskeratotic cells was observed. Based on the pathological results, SUSR and FEP were ruled out, and FDE was diagnosed. To identify the offending component, provocation tests were warranted. The commercial product that was administered to the patient contained lactose and methylparaben other than the active ingredient, doxorubicin. Since the parenterally administered form of lactose product was unavailable in our hospital, it was agreed that the patient would be administered pure doxorubicin without the previously mentioned components upon the fourth TACE. The skin lesion showed significant improvement in days that followed, and the patient has consequently been discharged.Among the anti-neoplastic agents, dacarbazine and procarbazine are known to cause FDE. 6 Although three cases of FEP induced by doxorubicin have previously been reported, FDE by doxorubicin were not reported. 7 On the other hand, two cases of FDE by lactose were reported. 8,9 Thus, to find the offending drug, the result of the fourth TACE is looked forward to.In the present case study, all the clues pertaining to a diagnosis, including the patient's history, symptoms, time to onset, location and manifestation of the lesion, as well as a review of the available literatures strongly suggested SUSR. However, the skin biopsy specimens did not reveal the presence of subcutaneous fat necrosis or dyskeratosis of the epidermis, and this led to the correct diagnosis of FDE.We recommend to postulate FDE as a possible diagnosis in cases where the patient repeatedly complains of a skin rash with severe abdominal pain after each round of TACE.

Novelin vivoobservations of scrotalNannizzia gypseainfection

“…However, the characteristic septated navicular macroconidia of this fungus were not found, but which was found in the abdomen and extremities scutular N. gypsea infection of a patient who was HIV positive. 9 The white appearance of many materials (paper, fabrics), substances (milk) and many natural phenomena (clouds, snow, fog) being 'white coloured' is related to light scattering, which was confirmed by physics experiments. We presume that the white appearance of the lesions comes from light incoherently scattering off the abundant hyphae.…”

“…According to our study using direct microscopy examination, periodic acid–Schiff stain, SEM and TEM, we found that large amounts of hyphae and arthrospores aggregate in the outer layer of the stratum corneum, resembling cultures of N. gypsea in vitro. However, the characteristic septated navicular macroconidia of this fungus were not found, but which was found in the abdomen and extremities scutular N. gypsea infection of a patient who was HIV positive …”