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Nakamura T, Yamauchi M, Sonoda S, Aharen D, Ikemura M, Kohagura K, Kusunose K. Green Nails, Red Alert: An Unusual Exit site infection Presentation. Perit Dial Int 2024:8968608241234529. [PMID: 38445494 DOI: 10.1177/08968608241234529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/07/2024] Open
Abstract
Green nail syndrome is an infectious nail disorder caused most commonly by Pseudomonas aeruginosa. We report a rare case of peritoneal dialysis (PD) exit site infection (ESI) accompanied by P. aeruginosa-associated green nail syndrome. The patient was treated with oral and topical antibiotics without the need for PD catheter removal. We aim to emphasise the importance of nail assessment for ESI in patients undergoing PD.
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Affiliation(s)
- Takuto Nakamura
- Department of Internal Medicine, Nishizaki Hospital, Okinawa, Japan
| | - Marino Yamauchi
- Department of Cardiovascular Medicine, Nephrology and Neurology, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan
| | - Shinichiro Sonoda
- Department of Cardiovascular Medicine, Nephrology and Neurology, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan
| | - Daigo Aharen
- Department of Cardiovascular Medicine, Nephrology and Neurology, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan
| | - Masaki Ikemura
- Department of Cardiovascular Medicine, Nephrology and Neurology, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan
| | - Kentaro Kohagura
- Department of Nephrology, Dialysis Unit, University Hospital of the Ryukyus, Okinawa, Japan
| | - Kenya Kusunose
- Department of Cardiovascular Medicine, Nephrology and Neurology, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan
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2
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Shi L, Feng Y, Shi D. Two Cases of Superficial Fungal Infection Caused by Non-Albicans Candida Species Manifest Greenish-black Discoloration. Infect Drug Resist 2024; 17:665-672. [PMID: 38405052 PMCID: PMC10885819 DOI: 10.2147/idr.s438079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Accepted: 01/22/2024] [Indexed: 02/27/2024] Open
Abstract
The clinical manifestation of superficial candidiasis varies depending on the infectious sites and causative Candida species that brings a great challenge to diagnose or treat without mycological or pathological evidence in clinical settings. Oral mucosal candidiasis and onychomycosis are most common types of superficial candidiasis. Typically, oral mucosal candidiasis manifests as white or erythematous thrush coated on the tongue and other interior oral cavity; and onychomycosis caused by Candida spp. presents with thick, fragile, or cracked fingernails or toenails in yellow or white discoloration. Here, we report one case of patient with a black hairy tongue caused by Candida tropicalis and one case of greenish discolored onychomycosis caused by Candida parapsilosis. The cases of superficial candidiasis with the same discolored lesions were searched in literature and compared with our cases in clinical manifestation, causative pathogen and treatment. These cases highlight the importance of mycological diagnosis for identifying non-Candida albicans Candida species (NCAC) in superficial infections to guide an effective therapy.
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Affiliation(s)
- Leyao Shi
- The Second Clinical Medical College, Shandong University of Traditional Chinese Medicine, Jinan, Shandong, People's Republic of China
| | - Yahui Feng
- The Laboratory of Medical Mycology, Jining No. 1 People's Hospital, Jining, Shandong, People's Republic of China
| | - Dongmei Shi
- The Laboratory of Medical Mycology, Jining No. 1 People's Hospital, Jining, Shandong, People's Republic of China
- Department of Dermatology, Jining No. 1 People's Hospital, Jining, Shandong, People's Republic of China
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3
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Yu Q, Hu S, Li W, Yang L. Case report: Green nail syndrome in an epidemic prevention volunteer during the outbreak of the Omicron in Shanghai. Front Public Health 2022; 10:1009517. [PMID: 36203662 PMCID: PMC9530803 DOI: 10.3389/fpubh.2022.1009517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Accepted: 09/05/2022] [Indexed: 01/27/2023] Open
Abstract
Green nail syndrome (GNS) is an infectious disorder characterized by greenish discoloration of the nail plate. Pseudomonas aeruginosa is the most common organism that causes GNS. It is an opportunistic human pathogen that preferentially colonizes moist environments, and thus, it usually affects patients with a history of prolonged exposure to moist environments. Here, we describe a case of GNS in an epidemic prevention volunteer that was caused by wearing personal protective equipment for prolonged durations. The case was reported during the outbreak caused by the SARS-CoV-2 Omicron variant in Shanghai. After receiving information about his condition and proper treatment, the patient was cured.
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Affiliation(s)
- Qian Yu
- Department of Medical Mycology, Shanghai Dermatology Hospital, Tongji University School of Medicine, Shanghai, China
| | - Sheng Hu
- Central Laboratory, Shanghai Dermatology Hospital, Tongji University School of Medicine, Shanghai, China
| | - Wei Li
- Department of Medical Cosmetology, Shanghai Dermatology Hospital, Tongji University School of Medicine, Shanghai, China,*Correspondence: Wei Li
| | - Lianjuan Yang
- Department of Medical Mycology, Shanghai Dermatology Hospital, Tongji University School of Medicine, Shanghai, China,Lianjuan Yang
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4
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Yu Q, Wang Y, Yang H, Li W, Yang L. Case report: Novel use of the conventional method- chemical nail avulsion may be effective for treatment of green nail syndrome. Front Med (Lausanne) 2022; 9:991918. [PMID: 36091683 PMCID: PMC9452826 DOI: 10.3389/fmed.2022.991918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Accepted: 08/11/2022] [Indexed: 11/30/2022] Open
Abstract
Green nail syndrome (GNS) is a triad of green discoloration of the nail plate, proximal paronychia, and distal onycholysis. Pseudomonas aeruginosa is known to be the most common causative agent; however, there is no unified standard for the diagnosis and treatment of GNS. Thus, treatment is challenging and often refractory. Here, we report three representative cases with different predisposing factors, including trauma-related, occupation-related, and onychosis-related GNS. Patients with GNS accompanied by onycholysis were instructed to undergo chemical nail avulsion combined with topical antibiotics, and favorable curative effects were observed in all cases. Chemical nail avulsion with urea powder as a conventional method may be an effective treatment for GNS and warrants clinical generalization.
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Affiliation(s)
- Qian Yu
- Department of Medical Mycology, Shanghai Dermatology Hospital, Shanghai, China
| | - Yuanyuan Wang
- Department of Medical Mycology, Shanghai Dermatology Hospital, Shanghai, China
| | - Hong Yang
- Department of Medical Mycology, Shanghai Dermatology Hospital, Shanghai, China
| | - Wei Li
- Department of Medical Cosmetology, Shanghai Dermatology Hospital, Shanghai, China
- Wei Li,
| | - Lianjuan Yang
- Department of Medical Mycology, Shanghai Dermatology Hospital, Shanghai, China
- *Correspondence: Lianjuan Yang,
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Bieber K, Harder M, Ständer S, Boch K, Kridin K, Köhler B, Anemüller W, Ernst AL, Zillikens D, Cavalar M, Ludwig RJ. DNA-Chip-basierte Diagnose der Onychomykose und Tinea pedis. J Dtsch Dermatol Ges 2022; 20:1112-1122. [PMID: 35971577 DOI: 10.1111/ddg.14819_g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Accepted: 04/22/2022] [Indexed: 11/28/2022]
Abstract
HINTERGRUND UND ZIELE Onychomykose (OM) und Tinea pedis (TP) sind häufige Pilzinfektionen der Haut. Aktuell basiert die Diagnose vornehmlich auf mikroskopischem Direktnachweis und/oder Kultur. Beide Methoden haben jedoch eine geringe bis mäßige Sensitivität und benötigen teilweise mehrere Wochen, bis endgültige Laborergebnisse vorliegen. Um die Diagnose kutaner Pilzinfektionen zu verbessern, wurden PCR-basierte Methoden entwickelt. Hier haben wir hier die Sensitivität und Spezifität einer Chip-basierten Multiplex-PCR mit mikroskopischen Direktnachweis und verglichen. PATIENTEN UND METHODIK In einer monozentrischen, prospektiven Studie wurden bei Patienten mit Verdacht auf OM (n = 67) oder TP (n = 73) Schuppenpräparate entnommen und mittels mikroskopischem Direktnachweis, Kultur und DNA-Chip-Technologie der Erregernachweis durchgeführt. In einem weiteren Ansatz wurde überprüft, ob Abstriche als Alternative zur Entnahme eines Schuppenpräparates verwendet werden können. Hierfür wurden 24 weitere OM/TP-Patienten rekrutiert und die Ergebnisse der DNA-Chip-Technologie aus Abstrichen mit denen aus den Schuppenpräparaten verglichen. ERGEBNISSE Im Vergleich aller Methoden hatte die DNA-Chip-Technologie die höchste Sensitivität, eine Kombination von DNA-Chip-Technologie mit mikroskopischem Direktnachweis erhöhte dies weiter. Ergebnisse dieser kombinierten Labordiagnostik sind innerhalb von 24 Stunden verfügbar. Der Vergleich der Probenentnahmetechniken (Abstrich beziehungsweise Schuppenpräparat) zeigte vergleichbare Ergebnisse. SCHLUSSFOLGERUNGEN Die molekulare Diagnostik (mittels DNA-Chip-Technologie) hat eine hohe Sensitivität für die OM- und TP-Diagnostik, insbesondere in Kombination mit dem mikroskopischen Direktnachweis.
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Affiliation(s)
- Katja Bieber
- Lübeck Institute of Experimental Dermatology, University of Lübeck, Lübeck, Germany
| | | | - Sascha Ständer
- Department of Dermatology, University of Lübeck, Lübeck, Germany
| | - Katharina Boch
- Department of Dermatology, University of Lübeck, Lübeck, Germany
| | - Khalaf Kridin
- Lübeck Institute of Experimental Dermatology, University of Lübeck, Lübeck, Germany.,Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel
| | - Birgit Köhler
- Department of Dermatology, University of Lübeck, Lübeck, Germany
| | | | - Anna Lara Ernst
- Lübeck Institute of Experimental Dermatology, University of Lübeck, Lübeck, Germany
| | - Detlef Zillikens
- Department of Dermatology, University of Lübeck, Lübeck, Germany
| | | | - Ralf J Ludwig
- Lübeck Institute of Experimental Dermatology, University of Lübeck, Lübeck, Germany
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6
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Bieber K, Harder M, Ständer S, Boch K, Kridin K, Köhler B, Anemüller W, Ernst AL, Zillikens D, Cavalar M, Ludwig RJ. DNA chip‐based diagnosis of onychomycosis and tinea pedis. J Dtsch Dermatol Ges 2022; 20:1112-1121. [DOI: 10.1111/ddg.14819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Accepted: 04/22/2022] [Indexed: 11/30/2022]
Affiliation(s)
- Katja Bieber
- Lübeck Institute of Experimental Dermatology University of Lübeck Lübeck Germany
| | | | - Sascha Ständer
- Department of Dermatology University of Lübeck Lübeck Germany
| | - Katharina Boch
- Department of Dermatology University of Lübeck Lübeck Germany
| | - Khalaf Kridin
- Lübeck Institute of Experimental Dermatology University of Lübeck Lübeck Germany
- Azrieli Faculty of Medicine Bar‐Ilan University Safed Israel
| | - Birgit Köhler
- Department of Dermatology University of Lübeck Lübeck Germany
| | | | - Anna Lara Ernst
- Lübeck Institute of Experimental Dermatology University of Lübeck Lübeck Germany
| | | | | | - Ralf J. Ludwig
- Lübeck Institute of Experimental Dermatology University of Lübeck Lübeck Germany
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7
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Ouzounova-Raykova VV. Green nail syndrome on the nail plate and bed related with Enterococcus and Fusarium coinfection. Folia Med (Plovdiv) 2022; 64:547-550. [PMID: 35856120 DOI: 10.3897/folmed.64.e64004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Accepted: 03/27/2021] [Indexed: 11/12/2022] Open
Abstract
Abstract.
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8
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Löser CR, Nenoff P, Mainusch O, Dippel E, Balakirski G. Häufige Nagelerkrankungen: Diagnostik und Therapie. J Dtsch Dermatol Ges 2021; 19:1761-1776. [PMID: 34894183 DOI: 10.1111/ddg.14627_g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Accepted: 08/05/2021] [Indexed: 11/27/2022]
Affiliation(s)
- Christoph R Löser
- Hautklinik, Hauttumorzentrum, Klinikum Ludwigshafen GmbH, Ludwigshafen
| | - Pietro Nenoff
- Labor für medizinische Mikrobiologie, Rötha/OT Mölbis
| | | | - Edgar Dippel
- Hautklinik, Hauttumorzentrum, Klinikum Ludwigshafen GmbH, Ludwigshafen
| | - Galina Balakirski
- Zentrum für Dermatologie, Allergologie und Dermatochirurgie, HELIOS Universitätsklinikum Wuppertal, Universität Witten/Herdecke, Wuppertal
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9
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Löser CR, Nenoff P, Mainusch O, Dippel E, Balakirski G. Common diseases of the nail: Diagnosis and therapy. J Dtsch Dermatol Ges 2021; 19:1761-1775. [PMID: 34862725 DOI: 10.1111/ddg.14627] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Accepted: 08/05/2021] [Indexed: 11/27/2022]
Abstract
This review focuses on nail changes that do not belong to the group of benign or malignant nail tumors. These common afflictions of the nail include structural changes in and under the nail plate as well as inflammation around and in the nail bed. They include onychomycoses, nail psoriasis, onychodystrophies, subungual hematoma, paronychia, ingrown nails and pincer nails. Due to the peculiar anatomy and physiological growth conditions of the nail, the pathology does not necessarily stem from the site of the clinical problem and calls for careful inspection and interpretation.
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Affiliation(s)
- Christoph R Löser
- Department for Skin Diseases and Skin Tumors, Klinikum Ludwigshafen GmbH, Ludwigshafen
| | - Pietro Nenoff
- Laboratory for Medical Microbiology, Rötha/OT Mölbis
| | | | - Edgar Dippel
- Department for Skin Diseases and Skin Tumors, Klinikum Ludwigshafen GmbH, Ludwigshafen
| | - Galina Balakirski
- Center for Dermatology, Allergology and Dermatosurgery, HELIOS University Hospital Wuppertal, University of Witten/Herdecke, Wuppertal
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10
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Pereira PP, Nunes Filho M, Moreira TDA, Duarte Silva Malvino L, de Araújo LB, Dos Santos Pedroso R, Ângela Ribeiro M. Hand-foot syndrome and nail disorders secondary to treatment with paclitaxel: Is there a relationship with the presence of fungi? J Oncol Pharm Pract 2021; 28:1798-1806. [PMID: 34590523 DOI: 10.1177/10781552211043752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
INTRODUCTION This study aimed to evaluate the frequency of nail disorders and the presence of fungi on the nails of the hands and feet of patients with hand-foot syndrome secondary to treatment with paclitaxel. METHODS Prospective study, carried out from October 2018 to December 2019, which included 81 patients undergoing treatment for breast cancer using paclitaxel and had signs and or symptoms of hand-foot syndrome with or without nail disorders. The data were collected through interviews guided by a structured questionnaire, information from medical records and reports of mycological exams. RESULTS The average age of women was 54.7 ± 7.4 years. Nail disorders occurred in 69 patients (85.2%), and of these, 43 (62.3%) were positive for fungi. The fungi were yeasts (n = 38; 69%), dermatophytes (n = 15; 27.2%) and non-dermatophyte filamentous fungi (n = 8; 14.5%). CONCLUSIONS Nail disorders were the most frequent manifestations in patients with hand-foot syndrome treated with paclitaxel and occurred in 85.2% of them. It was evidenced that fungi are present on the nails of these patients and can occur in up to 65.28%. The most prevalent fungi were Candida and Trichophyton. The nail lesion was associated with the type of treatment protocol used by the patient. The results of the study point to the need to select safe management alternatives for patients, so they can prevent nail lesions and prevent the proliferation of fungi, consequently reducing negative life impact during treatment.
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Affiliation(s)
- Paulina Patente Pereira
- Post-graduate Program in Health Sciences, Faculty of Medicine, Federal University of Uberlândia (UFU), Brazil
| | - Mário Nunes Filho
- Multiprofessional Residency Program, Faculty of Medicine, UFU, Brazil
| | | | | | | | - Reginaldo Dos Santos Pedroso
- Post-graduate Program in Health Sciences, Faculty of Medicine, Federal University of Uberlândia (UFU), Brazil.,Technical School of Health, UFU, Brazil
| | - Maria Ângela Ribeiro
- Multiprofessional Residency Program, Faculty of Medicine, UFU, Brazil.,Clinical Pharmacy, Hospital das Clínicas, UFU, Brazil
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11
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Reinecke JK, Hinshaw MA. Nail health in women. Int J Womens Dermatol 2020; 6:73-79. [PMID: 32258335 PMCID: PMC7105659 DOI: 10.1016/j.ijwd.2020.01.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2019] [Revised: 01/22/2020] [Accepted: 01/29/2020] [Indexed: 11/20/2022] Open
Abstract
Healthy nails are functionally and cosmetically important to the daily work of women. The globally increasing market for nail cosmetics reflects the importance of the appearance of nails. This article details the composition of a healthy nail, diagnosis and treatment of nail disorders, use of nail cosmetics and their risks, the impact of the aging process on nails, and the relative risks to nail salon workers. Knowledge of these issues will prepare health care providers and patients to maintain healthy nails throughout their lives.
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Affiliation(s)
| | - Molly A. Hinshaw
- Department of Dermatology, University of Wisconsin-Madison, Madison, WI, United States
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12
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Nail dermoscopy (onychoscopy) is useful in diagnosis and treatment follow-up of the nail mixed infection caused by Pseudomonas aeruginosa and Candida albicans. Postepy Dermatol Alergol 2018; 35:327-329. [PMID: 30008657 PMCID: PMC6041709 DOI: 10.5114/ada.2018.76232] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2017] [Accepted: 10/01/2017] [Indexed: 02/03/2023] Open
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13
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Arce M, Gutiérrez-Mendoza D. Fungal Paronychia. Clinical, Diagnosis and Treatment Aspects. CURRENT FUNGAL INFECTION REPORTS 2017. [DOI: 10.1007/s12281-017-0286-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
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14
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Nenoff P, Schorlemmer B, Uhrlaß S, Baunacke A, Baunacke A, Friedrichs C, Iffländer J, Syhre E, Schneider A, Krüger C, Maier T. [Onychocola canadensis Sigler in onychomycosis : A new dermatophyte-like mould in Germany]. Hautarzt 2017; 67:739-49. [PMID: 26758910 DOI: 10.1007/s00105-015-3755-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Moulds or non-dermatophyte moulds (NDM) are being increasingly isolated as causative agent of onychomycoses. Known causes of a NDM-OM are Scopulariopsis brevicaulis, Fusarium, Aspergillus, Acremonium, Neoscytalidium dimidiatum, Arthrographis kalrae, and Chaetomium. In this article, 5 patients with suspected nail infection due to Onychocola canadensis are reported for the first time in Germany. Systemic antifungal agents are not considered to be effective in NDM onychomycosis. In individual cases, however, terbinafine seems to be effective in Onychocola canadensis infection of the nails. Treatment of choice represents, however, nontraumatic nail avulsion using 40 % urea ointment followed by antifungal nail lacquer with ciclopirox olamine or amorolfine.
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Affiliation(s)
- P Nenoff
- Labor für medizinische Mikrobiologie, Mölbiser Hauptstraße 8, 04571, Rötha/OT Mölbis, Deutschland.
| | - B Schorlemmer
- Institut für Medizinische Diagnostik Greifswald, Pappelallee 1, 17489, Greifswald, Deutschland
| | - S Uhrlaß
- Labor für medizinische Mikrobiologie, Mölbiser Hauptstraße 8, 04571, Rötha/OT Mölbis, Deutschland
| | - A Baunacke
- Hautarztpraxis Dr. Annegret Baunacke, Hauptstr. 58, 01454, Radeberg, Deutschland
| | - A Baunacke
- Hautarztpraxis Dr. Annegret Baunacke, Hauptstr. 58, 01454, Radeberg, Deutschland
| | - C Friedrichs
- Medizinisches Labor Ostsachsen, Mikrobiologie Görlitz, Alfred-Fehler-Straße 18, 02827, Görlitz, Deutschland
| | - J Iffländer
- Hautarztpraxis Dr. Jens Iffländer, Schützenstr. 8, 14943, Luckenwalde, Deutschland
| | - E Syhre
- Hautarztpraxis Dr. Barbara und Ellen Syhre, Leipziger Straße 12, 04720, Döbeln, Deutschland
| | - A Schneider
- Hautarztpraxis Dr. Angela Schneider, Rimbeckerstraße 34a, 38855, Wernigerode, Deutschland
| | - C Krüger
- Labor für medizinische Mikrobiologie, Mölbiser Hauptstraße 8, 04571, Rötha/OT Mölbis, Deutschland
| | - T Maier
- Microbiological Laboratory/R&D Bioanalytics, Bruker Daltonik GmbH, Fahrenheitstr. 4, 28359, Bremen, Deutschland
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15
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Wang W, Yu J, Fan CY, Liu S, Zheng X. Stability of the distal phalanx fracture - A biomechanical study on the importance of the nail and the influence of fixation by crossing Kirschner wires. Clin Biomech (Bristol, Avon) 2016; 37:137-140. [PMID: 27451079 DOI: 10.1016/j.clinbiomech.2016.07.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2015] [Revised: 05/08/2016] [Accepted: 07/05/2016] [Indexed: 02/07/2023]
Abstract
BACKGROUND With respect to the stability of displaced distal-phalanx fracture, the relevance of nail loss and the biomechanical effects of fixation using crossed Kirschner wires have not been investigated. The present study aimed to determine whether the nail or the type of fixation contributes to stabilizing distal-phalanx fracture. METHODS In 48 specimens (fingers), a model of the comminuted fracture of the distal phalanx (AO type A3) was created by resecting a 1-mm osseous segment from the distal phalanx. Specimens were assigned to one of four groups, depending on whether the fracture was accompanied with nail loss, and whether the fracture fixation employed a single Kirschner wire or a crossing of two Kirschner wires. Each specimen was subjected to either a bending or a torsion test. FINDINGS Regardless of the fixation form, the mean peak bending and torsion forces were higher for the specimens with the nail intact. Furthermore, these forces were also higher in specimens which had received fixations based on the Kirschner wires, compared to those specimens which had received fixations based on a single Kirschner wire. The highest mean peak torque 1.39 (0.12) N·m was found for the specimens with no nail loss and fixation using two crossed Kirschner wires, while the lowest mean peak torsion 0.46 (0.02) N·m was found for specimens with nail loss and fixation using a single Kirschner wire. INTERPRETATION Our results suggest that the nail can provide additional stability for comminuted fractures of the distal phalanx after fixation. Furthermore, when nail loss occurs, fixation using two crossed Kirschner wires can provide significantly more stability than fixation using single Kirschner wire.
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Affiliation(s)
- Wei Wang
- Department of Orthopedics, Shanghai Sixth People's Hospital (East Campus), 222 West No. 3 Huanhu Road, Shanghai 201306, PR China.
| | - Jia Yu
- Orthopedics Institute, Medical College of Soochow University, 708 Renmin Road, Suzhou, Jiangsu 215006, PR China.
| | - Cun-Yi Fan
- Department of Orthopedics, Shanghai Jiaotong University Affiliated of Sixth People's Hospital, 600 Yishan Road, Shanghai 200233, PR China.
| | - Shen Liu
- Department of Orthopedics, Shanghai Jiaotong University Affiliated of Sixth People's Hospital, 600 Yishan Road, Shanghai 200233, PR China.
| | - Xianyou Zheng
- Department of Orthopedics, Shanghai Jiaotong University Affiliated of Sixth People's Hospital, 600 Yishan Road, Shanghai 200233, PR China
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16
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Bombace F, Iovene MR, Galdiero M, Martora F, Nicoletti GF, D'Andrea M, Della Pepa ME, Vitiello M. Non-dermatophytic onychomycosis diagnostic criteria: an unresolved question. Mycoses 2016; 59:558-65. [DOI: 10.1111/myc.12504] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2015] [Revised: 03/07/2016] [Accepted: 03/08/2016] [Indexed: 11/28/2022]
Affiliation(s)
- Francesca Bombace
- Department of Experimental Medicine; Division of Microbiology; Second University of Naples; Naples Italy
| | - Maria Rosaria Iovene
- Department of Experimental Medicine; Division of Microbiology; Second University of Naples; Naples Italy
| | - Marilena Galdiero
- Department of Experimental Medicine; Division of Microbiology; Second University of Naples; Naples Italy
| | - Francesca Martora
- Department of Experimental Medicine; Division of Microbiology; Second University of Naples; Naples Italy
| | - Giovanni Francesco Nicoletti
- Multidisciplinary Department of Medical-Surgical and Dental Specialties; Second University of Naples; Naples Italy
| | - Mirella D'Andrea
- Multidisciplinary Department of Medical-Surgical and Dental Specialties; Second University of Naples; Naples Italy
| | - Maria Elena Della Pepa
- Department of Experimental Medicine; Division of Microbiology; Second University of Naples; Naples Italy
| | - Mariateresa Vitiello
- Department of Clinical Pathology; Virology Unit; “San Giovanni di Dio e Ruggi d'Aragona Hospital”; Salerno Italy
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Raam R, DeClerck B, Jhun P, Bright A, Herbert M. That's Some Weird Nail Polish You Got There! Ann Emerg Med 2015; 66:585-8. [PMID: 26590739 DOI: 10.1016/j.annemergmed.2015.10.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Affiliation(s)
- Ryan Raam
- Department of Emergency Medicine, University of Southern California, Los Angeles, CA.
| | - Brittney DeClerck
- Departments of Pathology and Dermatology, University of Southern California, Los Angeles, CA
| | - Paul Jhun
- Department of Emergency Medicine, University of Southern California, Los Angeles, CA
| | - Aaron Bright
- Department of Emergency Medicine, University of Southern California, Los Angeles, CA
| | - Mel Herbert
- Department of Emergency Medicine, University of Southern California, Los Angeles, CA
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Całkosiński I, Płoneczka-Janeczko K, Ostapska M, Dudek K, Gamian A, Rypuła K. Microbiological Analysis of Necrosols Collected from Urban Cemeteries in Poland. BIOMED RESEARCH INTERNATIONAL 2015; 2015:169573. [PMID: 26301242 PMCID: PMC4537714 DOI: 10.1155/2015/169573] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/23/2015] [Accepted: 07/05/2015] [Indexed: 11/17/2022]
Abstract
Decomposition of organic matter is the primary function in the soil ecosystem, which involves bacteria and fungi. Soil microbial content depends on many factors, and secondary biological and chemical contaminations change and affect environmental feedback. Little work has been done to estimate the microbiological risk for cemetery employees and visitors. The potential risk of infection for people in the cemetery is primarily associated with injury and wound contamination during performing the work. The aim of this study was to analyze the microbiota of cemetery soil obtained from cemeteries and bacterial composition in selected soil layers encountered by gravediggers and cemetery caretakers. The most common bacterial pathogens were Enterococcus spp. (80.6%), Bacillus spp. (77.4%), and E. coli (45.1%). The fungi Penicillium spp. and Aspergillus spp. were isolated from 51% and 6.4% of samples, respectively. Other bacterial species were in the ground cemetery relatively sparse. Sampling depth was not correlated with bacterial growth (p > 0.05), but it was correlated with several differences in microbiota composition (superficial versus deep layer).
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Affiliation(s)
- Ireneusz Całkosiński
- Laboratory of Neurotoxicology and Environmental Diagnosis, Faculty of Health Science, Wroclaw Medical University, 51-618 Wroclaw, Poland
| | - Katarzyna Płoneczka-Janeczko
- Division of Infectious Diseases and Veterinary Administration, Department of Epizootiology and Clinic of Birds and Exotic Animals, Faculty of Veterinary Medicine, Wroclaw University of Environmental and Life Sciences, 50-366 Wroclaw, Poland
| | - Magda Ostapska
- Laboratory of Neurotoxicology and Environmental Diagnosis, Faculty of Health Science, Wroclaw Medical University, 51-618 Wroclaw, Poland
| | - Krzysztof Dudek
- Department of Logistics and Transport Systems, Faculty of Mechanical Engineering, Wroclaw University of Technology, 50-371 Wroclaw, Poland
| | - Andrzej Gamian
- Department of Immunology of Infectious Diseases, Institute of Immunology and Experimental Therapy, 53-114 Wroclaw, Poland
| | - Krzysztof Rypuła
- Division of Infectious Diseases and Veterinary Administration, Department of Epizootiology and Clinic of Birds and Exotic Animals, Faculty of Veterinary Medicine, Wroclaw University of Environmental and Life Sciences, 50-366 Wroclaw, Poland
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Chiriac A, Brzezinski P, Foia L, Marincu I. Chloronychia: green nail syndrome caused by Pseudomonas aeruginosa in elderly persons. Clin Interv Aging 2015; 10:265-7. [PMID: 25609938 PMCID: PMC4298286 DOI: 10.2147/cia.s75525] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Green nails, also known as chloronychia or green nail syndrome, are characterized by green discoloration of the nail plate (greenish-yellow, greenish-brown, greenish-black), proximal chronic non-tender paronychia, and distolateral onycholysis. The cause is Pseudomonas aeruginosa infection of the nail plate in persons whose hands are constantly exposed to water, soaps, and detergents or are subject to mechanical trauma, especially in the elderly. Green or black coloration of the nails should raise suspicion for Pseudomonas infection and be treated with an oral quinolone (ciprofloxacin), particularly in aged patients. We present three cases of green nails in elderly persons.
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Affiliation(s)
- Anca Chiriac
- Apollonia University, Iasi, Romania ; Nicolina Medical Center, Department of Dermatology, Iasi, Romania ; "P.Poni" Institute of Macromolecular Chemistry, Iasi, Romania
| | - Piotr Brzezinski
- Department of Dermatology, 6th Military Support Unit, Ustka, Poland
| | - Liliana Foia
- Grigore T. Popa University of Medicine and Pharmacy, Iasi, Romania
| | - Iosif Marincu
- Victor Babes University of Medicine and Pharmacy, Timisoara, Romania
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20
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Müller S, Ebnöther M, Itin P. Green Nail Syndrome (Pseudomonas aeruginosa Nail Infection): Two Cases Successfully Treated with Topical Nadifloxacin, an Acne Medication. Case Rep Dermatol 2014; 6:180-4. [PMID: 25202260 PMCID: PMC4152926 DOI: 10.1159/000365863] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Green nail syndrome (GNS) caused by Pseudomonas aeruginosa is the most common bacterial nail infection. The treatment of GNS is challenging in many cases and recommendations based on clinical trials are lacking. We report two cases with GNS successfully treated with off-label use of topical nadifloxacin, a fluoroquinolone approved for acne and bacterial skin infections in some countries.
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Affiliation(s)
- Simon Müller
- Department of Dermatology, University Hospital Basel, Basel, Switzerland
| | - Myriam Ebnöther
- Department of Dermatology, University Hospital Basel, Basel, Switzerland
| | - Peter Itin
- Department of Dermatology, University Hospital Basel, Basel, Switzerland
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