ISSN:
1365-4632
Source:
Blackwell Publishing Journal Backfiles 1879-2005
Topics:
Medicine
Notes:
A 20-year-old man presented with pitted keratolysis (PK), demonstrating the typical crateriform pits on the hallux ( 〈link href="#f1"〉Fig. 1), ball of the foot, and on the interdigital surface. The involved keratin specimen was obtained by a shaving technique and processed for transmission (TEM) and scanning (SEM) electron microscopy. The patient, who wore only sports shoes, had hyperhidrosis plantaris. He was treated with topical erythromycin with good results. Bacterial cultures from the lesions showed Corynebacterium sp.〈figure xml:id="f1"〉1〈mediaResource alt="image" href="urn:x-wiley:00119059:IJD035:IJD_035_f1"/〉Crateriform pits on the halluxTEM demonstrated filamentous coccoid bacteria in the keratin ( 〈link href="#f2"〉Fig. 2), showing transversal septations. Tunnel-like spaces were built inside the horny layer, where the bacteria showed a hairy surface ( 〈link href="#f3"〉Fig. 3).〈figure xml:id="f2"〉2〈mediaResource alt="image" href="urn:x-wiley:00119059:IJD035:IJD_035_f2"/〉Bacteria inside the stratum corneum (TEM, × 25,000)〈figure xml:id="f3"〉3〈mediaResource alt="image" href="urn:x-wiley:00119059:IJD035:IJD_035_f3"/〉Hairy surface from the causative agent (TEM, × 106,000)Crateriform pits ( 〈link href="#f4"〉Fig. 4) and small incipient lesions ( 〈link href="#f5"〉Fig. 5) were easily identified on the plantar surface by SEM. On examination of the floor of these lesions, tunnel openings were found ( 〈link href="#f6"〉Fig. 6) in which bacteria could be observed. With higher magnification, the transversal septation, seen by TEM, was also shown with SEM ( 〈link href="#f7"〉Fig. 7). The normal appearing plantar skin was also examined, showing incipient bacterial colonies with tunnels without keratin loss ( 〈link href="#f8"〉Fig. 8).〈figure xml:id="f4"〉4〈mediaResource alt="image" href="urn:x-wiley:00119059:IJD035:IJD_035_f4"/〉Pitted keratolysis with two incipient lesions on the right side (SEM, × 77.5)〈figure xml:id="f5"〉5〈mediaResource alt="image" href="urn:x-wiley:00119059:IJD035:IJD_035_f5"/〉Higher magnification of the incipient lesion from the right upper corner of 〈link href="#f4"〉Fig. 4 (SEM, × 310)〈figure xml:id="f6"〉6〈mediaResource alt="image" href="urn:x-wiley:00119059:IJD035:IJD_035_f6"/〉Tunnel openings in the floor of the pits (SEM, × 15,500)〈figure xml:id="f7"〉7〈mediaResource alt="image" href="urn:x-wiley:00119059:IJD035:IJD_035_f7"/〉Details of the bacteria; note the transversal septation (SEM, × 31,000)〈figure xml:id="f8"〉8〈mediaResource alt="image" href="urn:x-wiley:00119059:IJD035:IJD_035_f8"/〉The causative agent in tunnels in normal appearing skin (SEM, × 4650)
Type of Medium:
Electronic Resource
URL:
http://dx.doi.org/10.1046/j.1365-4362.2000.00035.x
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