Plantar verrucous carcinoma masquerading as toe web intertrigo

A 77-year-old man presented with a 6-month history of intractable toe web intertrigo located in the third and fourth web spaces of his left foot. Biopsy and histological examination confirmed the presence of a verrucous carcinoma. Verrucous carcinoma of the foot has been called epithelioma cuniculatum, a case arising in the intertriginous area of the foot is presented.     

Pyoderma gangrenosum manifesting as a cavitating lung lesion

We present a case of pyoderma gangrenosum (PG) mimicking a lung carcinoma. A 52-year-old woman presented with an unremitting cough. Computed tomography revealed a cavitating lung lesion. Bronchoscopy and biopsy were interpreted as squamous cell carcinoma. Following a staging mediastinoscopy, a sleeve lobectomy and chest-wall resection was performed. The pulmonary histopathological features suggested Wegener's granulomatosis; no malignancy was found. Three months postoperatively, wound breakdown led to dermatological review. A clinical diagnosis of cutaneous PG was made on the basis of the classic appearance of the surgical wounds and an ulcer on the upper back that had been present before surgery. The patient has been consistently negative for cytoplasmic-staining antineutrophil cytoplasmic antibodies, which supports the diagnosis of PG with cutaneous and pulmonary involvement. Lung manifestations of PG are rare. PG is amenable to systemic therapy. Pulmonary PG is a rare but important differential diagnosis that is not familiar to many physicians and surgeons in this type of presentation.     

Melanoma in a long-standing lesion of chromoblastomycosis

BACKGROUND: Chromoblastomycosis is a chronic cutaneous fungal infection where the presence of fibrous scars and continuous inflammation might be the propitious condition for the development of malignant neoplasms. METHODS: We report a case of cutaneous melanoma arising on a leg of a man that had been affected by extensive chromoblastomycosis for more than 30 years. RESULTS: A 70-year-old white man presented with an irregularly pigmented lesion over an area of fibrosis and verrucous lesions, previously diagnosed as chromoblastomycosis, on his left ankle. Histological examination showed an acral lentiginous melanoma, Clark level IV, thickness of 2.3 mm. Follow-up for 7 years showed no signs of recurrence or metastasis. CONCLUSIONS: The association between malignancy and chromoblastomycosis is very uncommon, but medical staff who deal with this disease should be attentive to this possibility, as early detection of these neoplasms will provide an adequate treatment, improving survival and quality of life for those patients.     

The antibacterial efficacy of econazole nitrate in interdigital toe web infections

Twenty-four patients with severe interdigital toe web infections and no evidence of dermatophyte colonization received randomized treatment with either econazole nitrate (Spectazole) or its vehicle. Of the patients treated with econazole nitrate, 88% had good to excellent responses, whereas no patient treated with the vehicle showed improvement. The total aerobic flora in the econazole group decreased 93%, with decreases in the large-colony diphtheroids, lipophilic diphtheroids, and gram-negative bacteria. The results of this study demonstrate that the antibacterial activity of econazole nitrate makes it an effective agent for the treatment of severe interdigital bacterial infections uncomplicated by dermatophyte colonization.     

肛周、脐部、趾间扁平湿疣伴玫瑰疹和硬下疳梅毒一例

患者女,22岁,未婚。肛周、脐部、趾间疣状增生物20 d。20 d前发现肛周散在绿豆大小扁平丘疹,皮疹表面湿润,无瘙痒、疼痛等不适。次日患者在脐、左足3、4趾间发现类似皮疹,之后皮疹逐渐增多、增大,部分融合,表面糜烂。3 d前趾间糜烂面散发恶臭。患者2个月前有非婚性行为,约40 d前右侧大阴唇上部一黄豆大小丘疹,无疼痛、瘙痒,丘疹扩大,表面坏死形成溃疡。患者既往体健,否认有输血史及吸毒史……     

Steatocystoma multiplex manifesting as a foreign body granuloma

A case of steatocystoma multiplex, which manifested as a foreign body granuloma, is presented. These multiple lesions appear on different body surfaces and were present for more than twenty years before diagnosis.