Ultrasonic evaluation of chronic sporotrichosis

Deep Fungal Infections of the Upper Extremity - A Review

Deep fungal infections are rare in the upper extremity. Vessel and nerve infection, synovitis, tenosynovitis, myofasciitis, arthritis and osteomyelitis have been discovered in literature. Treatment in most cases includes surgical procedure and antifungal agent use. Amputation is the final, most devastating for patient's functionality, solution. Intravenous antifungal drugs, frequently followed by oral administration, are important ancillary agents both for the initial treatment and the prevention of recurrence. We therefore performed a review of the current literature, in order to assemble the dispersed results of different studies and clarify the various aspects of upper extremity fungal infections.

Normal human skin echogram

Sector B-mode echograms of the stratum corneum from the top of pemphigus foliaceus bulla, 15/1,000 inch split-thickness skin graft including the epidermis and superficial dermis, and the whole skin with subcutaneous fat were compared with histologic sections. The corneo-epidermal and epidermo-dermal interfaces were not delineated either by 5, 10 or 15 MHz transducer. The subcutaneous fat exhibited an almost echolucent zone with weak echoes from the fibrous trabeculae or large blood vessels. Regional differences of in vivo normal skin echograms were studied on the forehead, abdomen, back, upper arm, thigh, lower leg and heel. The presence or absence of the cutaneous muscles, fascia or bone was clearly demonstrated. For the standard echogram of the skin, a 10 MHz transducer was considered appropriate, though the detailed echograms were obtained mostly in the deep dermal and subcutaneous structures.