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Notes: Background  Superficial white onychomycosis (SWO) is a distinct pattern of fungal nail invasion, which is usually treated with topical antifungals.Objective  This paper presents a case of SWO with deep penetration and records other similar cases.Methods  The clues to deep invasion of the nail plate are twofold: an inability to clear the discoloration by scraping the nail and a clinical involvement of the nail plate in the proximal nailfold area. Histology of the nail keratin will confirm deep penetration beyond the superficial layers of the nail plate.Results  In the light of this finding the authors propose a further subdivision of SWO to reflect previously unrecognized variants with therapeutic implications into: (i) the classical SWO type; (ii) the dual invasion of the nail plate, superficial and ventral; and (iii) the pseudo-SWO with deep fungal invasion of the nail plate.Conclusions  This subdivision of SWO allows the clinician to treat the patient appropriately using topical antifungals when the disease is restricted to the dorsum of the nail. Systemic drugs either in isolation or in combination with topical treatment are mandatory when deep penetration or ventral fungal invasion are observed.

Notes: Staphylococcus carnosus 833, inoculated into sausage meat, increased the level of methyl ketones, which contributed to the cured aroma. These ketones can arise from incomplete β-oxidation followed by two enzymatic activities: a thioesterase and a decarboxylase. In this study we identified the β-oxidative pathway (through the measure of 3-hydroxyacyl-CoA dehydrogenase activity) and the thioesterase activity in extracts of S. carnosus cells grown in the presence of different methyl esters. The β-oxidative system was induced by methyl esters and highest induction was found with a 12-carbon substrate. It was specific for medium chain length fatty acyl CoA substrates. Its maximal activity was observed at the end of stationary growth phase. HPLC analyses of acyl-CoA after incubation of cell extracts with palmitoyl-CoA showed that the β-oxidation system released preferentially long chain hydroxyacyl-CoAs, enoyl-CoAs, and acyl-CoAs. The time-course of intermediate formation indicated a precursor–product relationship indicative of a model of free intermediates which could be further deacylated by a thioesterase. The thioesterase activity was enhanced when S. carnosus was grown in the presence of methyl esters with at least 12 carbons and this enzyme was specific for short chain acyl-CoAs. The maximal activity was reached at the stationary growth phase.

Notes: Eccrine syringofibroadenoma (ESFA) is a rare disorder. We report the first case of ESFA of the nail apparatus, which presented as a yellow longitudinal onycholytic band of the left fourth finger over an intermittently painful subungual filamentous tumour. Histological examination showed features of ESFA with a digitate pattern of papillomatosis due to the specialized physiological longitudinal arrangement of the ridges in the nail bed. In addition, we describe a new feature of colloidal iron-positive clear cells. In our case, the presence of two types of cells with a central ductal differentiation and a significant amount of mucopolysaccharides in clear cells could suggest differentiation towards both the ductal and the secretory portion of the eccrine gland.

Notes: We report the first case of subungual perineurioma presenting as clubbing of one finger, an unusual clinical feature. Histological study showed a myxoid tumour but with, unexpectedly, a diffuse expression of CD34. Differential diagnoses between perineurioma and myxoid soft tissue tumours expressing CD34 are discussed.

Notes: Background  Recently, the expression profiles of the members of the complex hair keratin family have been determined in the human anagen hair follicle. In contrast, the details of hair keratin expression in the human nail unit are poorly known.Objectives  In order to fill this gap, we have performed an immunohistochemical study of the adult human nail unit by means of specific antibodies against nine hair keratins of both types (hHa2, hHb2, hHa5, hHb5, hHa1, hHb1, hHb6, hHa4 and hHa8) as well as three epithelial keratins (K5, K17 and K10).Methods  Formalin-fixed paraffin sections of adult nails were examined using monoclonal and polyclonal keratin antibodies, respectively. Longitudinal as well as transverse sections were investigated.Results  Our study revealed two types of epithelial tissue compartments in the nail unit. The first comprised the eponychium and hyponychium and the nail bed, which expressed only epithelial keratins. While keratins K5, K17 (basal) and K10 (suprabasal) were found in the orthokeratinizing eponychium and hyponychium, throughout, the nail bed epithelium expressed only K5 and K17. The second type comprised the apical and ventral matrix which exhibited a mixed pattern of epithelial and hair keratin expression. Thus, K5 and K17 were expressed in the entire multilayered basal cell compartment of the apical and ventral matrix; however, in the latter, K5 and K17 also occurred in the lowermost layers of the overlying keratogenous zone. The hair matrix keratin hHb5, but not its type II partner hHa5, was seen in the entire keratogenous zone of the apical and ventral matrix, but was also located in the uppermost cell layers of the basal compartment of the ventral matrix, where it overlapped with K5 and K17. Similar to their sequential expression in the hair follicle cortex, hair keratins hHa1, hHb1, hHb6 and hHa4 were consecutively expressed in the keratogenous zone of both the ventral and, albeit less distinctly, apical matrix, with hHa1 initiating in the lowermost cell layers. The expression of hHa8 in only single cortex cells of the hair follicle was also preserved in cells of the keratogenous zone. In the region of the so-called dorsal matrix, we observed two histologically and histochemically distinct types of epithelia: (i) a dominant type, histologically similar to the eponychium and an associated K5, K17 and K10 keratin pattern which clearly extended into the apical matrix, and (ii) a minor type, histologically resembling the postulated dorsal matrix without a granular layer and a cuticle, and exhibiting extended K5 expression as well as hair keratin expression in superficial cells.Conclusions  The coexpression of hHb5 with K5 and K17 in the uppermost cell layers of the basal compartment and the lowermost layers of the keratogenous zone of the ventral matrix prompts us to designate this region the prekeratogenous zone of the ventral matrix. The two alternating types of histology and keratin expression in the dorsal matrix identify this region as a transitional zone between the eponychium and the apical matrix. Finally, our data clearly show that the ventral matrix is the main source of the nail plate. In addition, the mixed scenario of hair and epithelial keratins, including demonstrable amounts of K10, in superficial cells of the apical matrix, lends support to the notion that the dorsal portion of the nail is generated by the apical matrix.

Notes: We biopsied longitudinal erythronychia in 16 subjects, and found an onychopapilloma in 14 cases and Bowen’s disease in the remaining two. Shared clinical features in addition to erythronychia (or sometimes an interrupted line made up of splinter haemorrhages) were typically a longitudinal marked ridge of the nail bed expanded at the distal nail bed as subungual keratosis, and associated localized onycholysis. The presentation of Bowen’s disease in this pattern has not been previously reported. In all cases of onychopapilloma of the nail bed, acanthosis and papillomatosis were evident, and were associated with a keratogenous zone identical to the nail matrix. In addition, we found multinucleate giant cells in two onychopapillomas. We have therefore suggested that the term ‘localized, distal, subungual keratosis with multinucleate cells’ should be replaced by ‘onychopapilloma’ (nail-producing papilloma).

Notes: Sequence analysis of a fragment of the cytochrome b gene in Decapterus russelli sampled from the Indo-Malay archipelago revealed two distinct mitochondrial clades (mean nucleotide divergence=2·2%) whose geographic distribution was heterogeneous (Nei's GST=0·416). This pointed to a complex pattern of genetic differentiation and demonstrated limited genetic exchange between populations in this highly mobile species.

Notes: Abstract. Pseudomembranous aspergillus bronchitis is considered as an early form of invasive pulmonary aspergillosis, a well-known airway infection in immunocompromised patients. Radiologic features concerning invasive aspergillosis of the airways have been reported. However, we describe here an unusual feature of invasive aspergillus bronchitis, never reported to date, observed in a double-lung transplanted patient. Chest radiograph and CT revealed significant peribronchial thickening without any parenchymal involvement.

Notes: [Auszug] In cortisone reductase deficiency (CRD), activation of cortisone to cortisol does not occur, resulting in adrenocorticotropin-mediated androgen excess and a phenotype resembling polycystic ovary syndrome (PCOS; refs. 1,2). This suggests a defect in the gene HSD11B1 encoding 11β-hydroxysteroid ...