Some cases of onychomycosis from north India in different working environments

Three fungi, Alternaria humicola, A. pluriseptata and Aspergillus niger are being reported as new probable etiologic filamentous fungi, causing onychomycosis. The morphology and physiology of these fungi is discussed.

Disuse contractures in a patient with tinea manuum and irritant contact dermatitis

Disuse contractures are reported in a patient with tinea manuum and irritant contact dermatitis. The case is presented to alert the physician to the potential for this problem in any patient with a chronic fissured dermatosis of the hands.

Onychomycosis

This article summarizes the diseases of the nail caused by fungi. The clinical appearance of the diseases are the key to understanding their causes. Therapy is updated. Specifically discussed are distal subungual onychomycosis, white superficial onychomycosis, proximal subungual onychomycosis, and onychomycosis in chronic mucocutaneous candidiasis.

Onychogryphosis

A case of onychogryphosis of the left index nail is presented. This classical toenail dystrophy in our case involves a fingernail and is associated with onychomycosis.

The high incidence of Tinea pedis and unguium in patients with Kaposi's sarcoma

Forty patients suffering from Kaposi's sarcoma (31 males, a females aged from 18 to 80 years) were examined for the presence of mycotic invasion of the toe-webs, toe-nails and soles. Fungi were found without exception in all patients. In 35 patients all three sites were invaded; the remaining 5 showed no involvement of the toe-nails. The causative agent was T. rubrum in 31 patients. T. mentagrophytes in 7, E. floccosum in 2. Four subjects with T. rubrum infection also showed a super-imposed C. albicans infection in the toe-webs. The skin tests with Trichophytin and Candidin yielded a mildly positive response to the former antigen in 4 cases and to the latter in 8 cases. The strikingly high percentage of affected cases in this group of patients with Kaposi's sarcoma is discussed.

Erythema nodosum in patients with tinea pedis and onychomycosis

To document association between erythema nodosum and concomitant fungus infection, we studied seven white women seen during a six-year period in our office practice. Five patients are presented. Unilateral erythema nodosum occurred in three patients on the same side as unilateral tinea. Tests with potassium hydroxide (KOH), cultures of nodules on Sabouraud agar and dermatophyte test medium (DTM), skin biopsy, and clinical examination ruled out nodular granulomatous perifolliculitis of Wilson. Lesions simulating erythema nodosum were produced when Trichophyton antigen was injected subcutaneously in the lower legs. All nodose and fungal lesions cleared after griseofulvin therapy. Fungus infection of feet or nails should be considered a possible cause of erythema nodosum when no other cause is apparent.