bromochloroacetic-acid and Hand-Dermatoses

Topics: Aged; Biopsy; Diagnosis, Differential; Female; Hand Dermatoses; Humans; Keratins; Skin

We report the case of a 12-year-old girl with a smooth muscle hamartoma of the right index finger. Smooth muscle hamartoma (SMH) is a congenital, relatively common disorder typically with predominance of autochthonal arrector pili muscles. An SMH can also rarely originate from smooth muscles of vessels in palmoplantar skin with the absence of pilosebaceous units. Because of overlapping histological features, the possibility of Becker's nevus being identical or associated with SMH has often been suspected by some authors.

Topics: Biopsy; Child; Diagnosis, Differential; Female; Fingers; Hamartoma; Hand Dermatoses; Humans; Keratins; Muscle, Smooth; Skin

Topics: Biomarkers; Cell Differentiation; Cell Proliferation; Erythema; Female; Hand Dermatoses; Humans; Keratins; Keratosis; Middle Aged

Although topical antifungal therapies for treating onychomycosis are available, the cure rate is unsatisfactorily low with a simultaneously high risk of recurrence. One reason might be the formation of dormant fungal cells by the pathogen, known as spores, which can survive in the affected nail keratin, thereby evading the effect of antifungal drugs. In this in vitro study, the ability of amorolfine and four other antimycotics (ciclopirox, bifonazole, terbinafine and fluconazole) to kill microconidia of the dermatophyte Trichophyton rubrum, chlamydospores of the dermatophyte Epidermophyton floccosum and blastospores of the yeast Candida albicans was extensively studied as these fungi occur predominantly in onychomycosis. The effectiveness of all five antimycotics depended on the drug concentration and the incubation time: a concentration of 10-1000 times the minimum inhibitory concentration against growing hyphae cells is needed to exert a sporicidal action. Amorolfine and ciclopirox showed the same sporicidal efficacy and kinetics for all three varieties of spores. Both were more effective than fluconazole and bifonazole against microconidia and chlamydospores as well as slightly more potent against chlamydospores and blastospores than terbinafine after 4 days of incubation and at concentrations of ≥10 μg ml(-1). Finally, sporicidal activity on the tested strains was demonstrated for all five different antimycotics used for onychomycosis treatment.

Topics: Antifungal Agents; Candida albicans; Ciclopirox; Epidermophyton; Fluconazole; Hand Dermatoses; Humans; Keratins; Microbial Sensitivity Tests; Morpholines; Nails; Naphthalenes; Onychomycosis; Pyridones; Spores, Fungal; Terbinafine; Trichophyton

Topics: Aged; Female; Hand Dermatoses; Humans; Japan; Keratins; Keratoderma, Palmoplantar

A 60-year-old female and a 59-year-old male each presented with a solitary circumscribed patch of depressed skin of the right thenar palm and right sole, respectively. Both lesions were present for approximately 30 years without a history of trauma or other inciting incident. Histologically, the lesions showed a well-demarcated abrupt decrease in the thickness of the stratum corneum with a central area of thinned stratum corneum and hypogranulosis. Inflammation was absent. Ultrastructurally, keratin filaments were evident in the stratum corneum, and a diminished granular cell layer was apparent. There was a decrease in maturation of the keratinocytes, however, no defects in corneodesmosomes or other ultrastructural components were identified. No evidence of human papilloma virus was detected by in situ hybridization studies. Based on these 2 cases and the 25 cases reported in the literature to date, this entity seems to represent a chronic localized non-inflammatory defect in keratinization on acral sites.

Topics: Alphapapillomavirus; Female; Hand Dermatoses; Humans; In Situ Hybridization; Keratinocytes; Keratins; Keratosis; Middle Aged; Skin

Circumscribed palmar or plantar hypokeratosis (CPH) is a rare skin disorder only recently described.. To determine the diagnostic features and to provide insight into the pathogenesis of CPH, with analysis of two new Japanese cases.. Dermoscopy, immunohistochemistry, electron microscopy, polymerase chain reaction amplification for human papillomavirus (HPV) DNA and 16S microbial rRNA gene profiling were conducted.. Dermoscopy showed characteristic features using both dry and jelly immersion observation; step-like desquamation and a homogeneous erythema with regularly distributed whitish spots. Immunohistochemistry revealed strong staining with anti-pankeratin antibody (AE1+AE3) and anti-keratin 16 antibody, and decreased expression of keratin 2e. EM revealed a breakage of the corneocytes within their cytoplasm, but structures for cell attachment were intact. HPV and lesion-specific bacteria were not detected.. The number of cases analyzed was two.. Hyperproliferative epidermal state along with enhanced corneocyte fragility may account for the unique features in CPH.

Topics: Aged; Bacteria; DNA, Viral; Female; Hand Dermatoses; Humans; Immunohistochemistry; Keratin-2; Keratins; Keratosis; Microscopy, Electron; Middle Aged; Papillomaviridae; Polymorphism, Restriction Fragment Length; RNA, Ribosomal, 16S; Staining and Labeling

Topics: Adolescent; Base Sequence; DNA Mutational Analysis; Follow-Up Studies; Foot Dermatoses; Genetic Predisposition to Disease; Hand Dermatoses; Humans; Japan; Keratins; Keratoderma, Palmoplantar, Diffuse; Keratosis; Male; Molecular Sequence Data; Mutation; Polymerase Chain Reaction; Risk Assessment; Severity of Illness Index

Six cases of spiny keratoderma were analyzed with hair specific antikeratin antibodies (AE13, AE14) and by electron microscopy. The keratotic column exhibited a different keratin birefringence and the underlying viable epidermis was less eosinophilic than the surrounding epidermis. AE13, which is specific for hair cortex, was positive in the lower column and variably positive in the viable epidermis, often beyond the columnar lesion. AE14 was negative in the lesion. Electron microscopy demonstrated features of keratinization of normal hair cortex, i.e. by the accretion of keratin filaments without production of keratohyalin or trichohyalin granules. Cementsomes (lamellar granules) and marginal bands were not produced as they are not formed in normal cortical keratinization. It was suggested that spiny keratoderma represents an ectopic hair formation of palms and soles.

Topics: Aged; Aged, 80 and over; Antibodies, Monoclonal; Female; Hair; Hand Dermatoses; Humans; Immunohistochemistry; Keratins; Keratoderma, Palmoplantar; Male; Middle Aged; Skin

Reactive perforating collagenosis is characterised by trans-epidermal elimination of collagen and is hypothesized to be both autosomally dominant and recessive. We report a family in which two brothers and a sister had lesions of reactive perforating collagenosis.

Topics: Adolescent; Child; Child, Preschool; Collagen; Collagen Diseases; Epithelium; Facial Dermatoses; Female; Genes, Dominant; Genes, Recessive; Hand Dermatoses; Humans; Hypopigmentation; Keratins; Keratosis; Male; Skin; Skin Diseases, Papulosquamous

An increasing number of syndromes with palmoplantar keratoderma (PPK) with associated diseases are being identified, representing a wide spectrum of distinct entities. At present only one case report has described the combination of marked anogenital leukokeratosis with diffuse PPK evolving in a collodion baby. We report a patient with a diffuse, nonprogressive PPK in combination with an intermittently pruritic, slowly progressive anogenital leukokeratosis. Hyperkeratosis of the perineal area was most pronounced and extended to the distal portion of the anal mucosa. The opalescent lesion was also visualized at the margin of the major labia. Vulvar structures were not otherwise involved or dystrophic. There were no signs or symptoms of ectodermal dysplasia. Specifically, the nails were normal and showed no signs of pachyonychia congenita. Other differential diagnoses included dyskeratosis congenita and white sponge nevus, which may be associated with anogenital leukokeratosis, but a keratoderma is not associated with these entities. Keratin immunocytochemistry showed marked expression of suprabasal K17 and absence of K6 and K16. Further examination of the initial case described by Itin and Rufli demonstrated the same expression pattern and supports the contention that these two cases represent the same entity.

Topics: Adult; Anal Canal; Female; Genital Neoplasms, Female; Hand Dermatoses; Humans; Immunohistochemistry; Keratins; Keratoderma, Palmoplantar, Diffuse; Leukoplakia; Skin

Clinical reports of hereditary palmoplantar keratoderma are generally based on a limited number of patients. In 1967 the prevalence in the northernmost county of Sweden (Norrbotten) was shown to be 0.55%. In 1982 it was possible to trace half of the original propositi from that study. Among these families, a severe clinical form with a presumed recessive inheritance could be distinguished. The clinical pictures in relatives of the original propositi were described, and other diseases were listed together with those in patients from previously performed studies. The frequency of dermatophytosis was 36.2%, which was equal to a prevalence of 37.6%. T. mentagrophytes occurred significantly more often and immunological factors, such as increased presence of blood group A, specific dermatophyte IgG antibodies, precipitating antibodies and an immunological in vitro reaction to keratin, supported differences in the distribution of dermatophytes. However, the amount of keratin was considered the most important factor for the affinity of dermatophytes to the palms and soles. A vesicular eruption along the hyperkeratotic border and a mononuclear cell infiltrate were often reported. Such reactions were interpreted as immunological reactions to dermatophytosis. Scaling and fissuring were considered clinical signs of dermatophyte infections and not a part of the originally reported clinical picture. Results of the histopathological study corresponded to previously reported descriptions of the Unna-Thost variety. However, it has recently been reported that the histopathological picture of this variety was based on histopathological features of epidermolytic palmoplantar keratoderma. The existence on the Continent of the Unna-Thost variety was therefore questioned. Histopathological features of epidermolytic palmoplantar keratoderma were not found in the County of Norrbotten and the designation "Diffuse HPPK type Norrbotten" has therefore been proposed. The histopathological picture of the presumed recessive variety did not differ from that of the dominant variety but ultrastructural characteristics differentiated it from Mal de Meleda and the dominant variety. It was therefore concluded that a new variety with a presumed recessive inheritance was found.

Topics: ABO Blood-Group System; Adolescent; Adult; Aged; Antibodies, Fungal; Arthrodermataceae; Child; Child, Preschool; Dermatomycoses; Female; Foot Dermatoses; Genes, Dominant; Genes, Recessive; Hand Dermatoses; Humans; Immunoglobulin E; Immunoglobulin G; Infant; Keratins; Keratoderma, Palmoplantar; Male; Middle Aged; Pedigree; Sweden; Tinea; Trichophytin; Trichophyton

Titers of anti-keratin antibodies (AKA) involving IgG and IgM fractions were determined by a solid-phase enzyme-linked immunsorbent assay (ELISA) and were found to be significantly higher on average in patients with pustulosis palmaris et plantaris (PPP) than in normal controls. Positive rates of IgG-AKA and IgM-AKA in sera of PPP patients were 50% and 66%, respectively. Following tonsillectomies, patients with high IgM-AKA titers that decreased after surgery were found to benefit by a marked improvement in their skin lesions. There was a close relationship between the degree of this improvement in the skin lesions and the changes in IgM-AKA titers after the operation. These results suggest that PPP may be a tonsil-related immunological skin disease.

Topics: Antibodies; Ecthyma, Contagious; Enzyme-Linked Immunosorbent Assay; Foot Dermatoses; Hand Dermatoses; Humans; Keratins; Middle Aged; Palatine Tonsil; Tonsillectomy

In 30% to 40% of cases atopic dermatitis (AD) is believed to be associated with autosomal dominant ichthyosis vulgaris (ADI). The diagnosis of ADI can be proved by the ultrastructural demonstration of a defective keratohyalin (KH) synthesis, resulting in minute granules of crumbly appearance in only one layer of granular cells. To investigate the suggested frequent association of ADI with AD, ultrastructural examination of dry skin of 49 AD patients was performed. Only in 2 patients abnormal KH was demonstrated by electron microscopy. 17 patients, including the 2 patients with abnormal KH, showed hyperlinear palms. The present study shows that hyperlinear palms and dry skin are in most cases a phenotypic marker of AD alone and not a sign of concomitant ADI. A histologically one-layered or absent stratum granulosum may occur in the dry skin of patients with only AD and does not indicate a manifestation of concomitant ADI in all cases.

Topics: Adolescent; Adult; Dermatitis, Atopic; Female; Foot Dermatoses; Hand Dermatoses; Humans; Hyalin; Ichthyosis; Keratins; Male; Skin; Skin Diseases

In order to clarify the relationship between the tonsils and pustulosis palmaris et plantaris (PPP), immunological investigations were performed focusing on keratin and antikeratin antibody. As materials, the tonsils, plantar skins and peripheral blood from the patients with PPP undergoing tonsillectomy were used. The results were summarized as follows: 1) Common keratin polypeptides reacting with monoclonal anti-keratin antibody were found both in the tonsillar epithelium and in the plantar skin. 2) High molecular weight keratin polypeptides were predominant in the tonsillar epithelium of the patients with PPP as in the plantar skin. 3) The antikeratin antibody titers in the sera of the patients with PPP were on a high level, and tended to decrease after tonsillectomy. 4) The antibody in the sera of the patients with PPP reacted with 67, 63 and 56 kd bands of keratin polypeptides. 5) The antikeratin antibody titers in the culture medium of the patients with PPP, especially in the tonsillar lymphocyte cultures, were on a high level. These results suggest the possibility that the keratin of the tonsillar epithelium and the antikeratin antibody in the serum may play an important role for pustule formation.

Topics: Antibodies; Electrophoresis, Polyacrylamide Gel; Enzyme-Linked Immunosorbent Assay; Epithelium; Fluorescent Antibody Technique; Foot; Foot Dermatoses; Hand Dermatoses; Humans; Immunoblotting; Keratins; Molecular Weight; Palatine Tonsil; Skin

The deposition of immunoglobulins and complement was examined in skin lesions of pustulosis palmaris et plantaris by applying a direct-immunofluorescence technique. Linear deposition of IgG and C3 was demonstrated in the horny layer in 5 cases out of 10. The antikeratinlayer antibody was measured using the sera of patients with PPP, and elevated levels were recorded in patients with a maximum ratio of 1:80. Light and electron-microscopical examinations revealed a structure similar to the epidermal keratin layer of the tonsillar epidermis and phagocytosis of the structure by macrophages. This is an interesting finding in view of the antigen of the epidermal keratin layer.

Topics: Adult; Antibodies; Complement C3; Female; Foot Dermatoses; Hand Dermatoses; Humans; Immunoglobulin G; Keratins; Male; Middle Aged; Palatine Tonsil

Light microscopy was used to examine the clinically normal palmar skin of 18 psoriatic patients (10 inactive and 8 active) and 18 non-psoriatic control patients. Histological changes in both epidermis and dermis vary with activity of the disease. The findings support the view that defective keratin formation precedes excessive proliferation of epidermal cells.

Topics: Biopsy; Hand Dermatoses; Humans; Keratins; Psoriasis; Skin

Topics: Adolescent; Adult; Carcinoma, Squamous Cell; Cell Membrane; Cell Nucleus; Child; Child, Preschool; Collagen; Cytoplasm; Female; Fibroblasts; Foot Dermatoses; Hand Dermatoses; Humans; Keratins; Keratosis; Leg; Male; Melanocytes; Microscopy, Electron; Middle Aged; Skin; Syndrome

Topics: Female; Hand Dermatoses; Humans; Keratins; Middle Aged; Nails

Topics: Blister; Dermatitis, Atopic; Dermatitis, Exfoliative; Extremities; Facial Dermatoses; Foot Dermatoses; Genes, Dominant; Genes, Recessive; Hand Dermatoses; Humans; Ichthyosis; Keratins; Keratosis; Microscopy, Electron; Ribosomes; Scalp Dermatoses; Sex Chromosomes; Skin; Thorax

Topics: Adult; Binding Sites; Coloring Agents; Dermatitis, Occupational; Dermatoglyphics; Ethanol; Female; Hand Dermatoses; Humans; Keratins; Pigmentation Disorders; Skin Absorption; Soaps; Water