History of zinc in agriculture

Zinc was established as essential for green plants in 1926 and for mammals in 1934. However, >20 y would pass before the first descriptions of zinc deficiencies in farm animals appeared. In 1955, it was reported that zinc supplementation would cure parakeratosis in swine. In 1958, it was reported that zinc deficiency induced poor growth, leg abnormalities, poor feathering, and parakeratosis in chicks. In the 1960s, zinc supplementation was found to alleviate parakeratosis in grazing cattle and sheep. Within 35 y, it was established that nearly one half of the soils in the world may be zinc deficient, causing decreased plant zinc content and production that can be prevented by zinc fertilization. In many of these areas, zinc deficiency is prevented in grazing livestock by zinc fertilization of pastures or by providing salt licks. For livestock under more defined conditions, such as poultry, swine, and dairy and finishing cattle, feeds are easily supplemented with zinc salts to prevent deficiency. Today, the causes and consequences of zinc deficiency and methods and effects of overcoming the deficiency are well established for agriculture. The history of zinc in agriculture is an outstanding demonstration of the translation of research into practical application.

Two episodes of axillary granular parakeratosis triggered by different causes: case report

Granular parakeratosis is an acquired disorder of keratinization characterized by keratotic papules and plaques located in the intertriginous areas. Its etiology is unknown. Some cases have been related to the application of deodorants and antiperspirants, local irritation or increased sweating; in other cases no precipitant factors have been found. We report a case of axillary granular parakeratosis in an adult male in whom the lesions appeared twice under different circumstances: the first time the lesions appeared after local irritation produced by an antiperspirant and/or the use of a paste containing zinc oxide; two years later, an identical eruption reappeared in both axillae, while using his habitual deodorant and without a preceding irritation of the zone; only excessive sweating was mentioned this time after a weight gain of 20 kg. On both occasions, the lesions disappeared completely a few days after using topical calcipotriol. A constitutional factor may predispose the development of granular parakeratosis, which must be considered a reaction pattern that can be induced by multiple different causes.

Granular parakeratosis: response to calcipotriene and brief review of current therapeutic options

A 34-year-old Hispanic woman presented with an 18-month history of an intermittent, asymptomatic eruption that began on her left axilla after using a depilatory cream containing corn starch and thioglycolate (Figure 1A). The eruption then spread to her right axilla and lower abdomen (Figure 1B). She reported worsening with deodorant use, but had been using the same deodorant for many years and had continued using it twice a day. Treatment with topical corticosteroids had not helped. The patient coincidentally had been started on isotretinoin 5 months previously for acne, but it had no effect on her axillary or abdominal lesions. Physical examination revealed multiple dark brown and black papules with a "stuck-on" appearance in both axillae and on the lower right abdomen. A biopsy of the left axilla revealed a thickened parakeratotic stratum corneum with retention of keratohyalin granules within the parakeratoric cells, which is considered diagnostic of granular parakeratosis (Figure 2). The patient was prescribed calcipotriene cream twice daily. After 2 weeks, she had complete resolution of the axillary lesions, but the abdominal lesions persisted. She has since had mild recurrences while using calcipotriene.

Reiter's syndrome in a patient with polyarthritis and nail involvement

An 8-year old boy with polyarthritis and nail involvement is presented in this report. Nail involvement in Reiter's syndrome is a rare condition that may include painless erythematous nduration of the base of the nail fold; subungual parakeratotic scaling and thickening opacification, ridging of the nail plate.

[Spontaneous remission of Kikuchi-Fujimoto disease (lymphadenopathy) with focal skin parakeratosis]

Kikuchi-Fujimoto disease is subacute, necrotizing lymphadenopathy affecting mainly young women, and manifested by cervical lymphadenopathy. It is often observed, and described in Asia, but in other world regions sporadically too. Etiology is unknown, but it has been postulated that this condition is induced by infectious factor. We described a case of 20-year-old Caucasian woman with diagnosis of Kikuchi-Fujimoto lymphadenopathy. First symptoms as a cervical lymph nodes enlargement 2 cm in diameter was associated with elevated body temperature, without associated symptoms of infection appeared about one year ago (data from history). Lymphadenopathy and general symptoms receded after empiric therapy with amoxicilin. Relapse of cervical lymphadenopathy alongshore sternocleidomastoid muscles bilateral to about 2 cm in diameter with pseudo-flu symptoms like fever and joints and muscles pains. Focal hiperpigmentation of abdomen, arms and legs skin appeared. In histopathology of collected lymph node histiocytic necrotizing lymphadenopathy without neutrophils infiltration Kikuchi type was diagnosed. In peripheral blood morphology transitional leucopenia 2.58 x 10(9)/l with granulocytopenia 0.64 x 10(9)/l was noted. Anemia and thrombocytopenia did not be observed. In serology active CMV, EBV or toxoplasmosis were excluded. In immunology presence of eleveted levels of anti-Jo, anti-nuclear and anticardiolipin antibodies was excluded too. Serum protein electrophoresis and additional biochemical parameters was normal. In chest X-ray and abdomen ultrasonography abnormalities was not found. In skin and muscles biopsy specimens focal parakeratosis was found. Despite no empiric antiinfectious therapy after 3-4 weeks remission of general symptoms and lymphadenopathy was noted.

Infantile granular parakeratosis: Recognition of two clinical patterns

Granular parakeratosis is an acquired, idiopathic disorder of keratinization typified by retention hyperkeratosis. It usually occurs in women at intertriginous sites. There have been only 2 reports of infants with granular parakeratosis to our knowledge. We describe 3 additional infants with granular parakeratosis. We demonstrate that infantile granular parakeratosis exhibits 2 clinical patterns: bilateral linear plaques in the inguinal folds; and erythematous geometric plaques underlying pressure points from the diaper. A thick, flakelike scale is present in both forms and is characteristic. Diaper wearing appears to play an important role in the genesis of infantile granular parakeratosis but the mechanisms are unclear. Therapeutic responsiveness to topical agents is ambiguous, however, spontaneous clearance after months to 1 year appears to be the rule.

Dermatophyte-related Granular Parakeratosis

A patient presented with a two-month history of an annular eruption on her back. Biopsies of this process revealed dermatophytosis and concurrent granular parakeratosis. This patient's eruption resolved completely with antifungal therapy suggesting that the fungal organisms caused the granular parakeratosis.

Granular parakeratosis: a case report and literature review

BACKGROUND

Granular parakeratosis is suspected to result from an error in epidermal differentiation, leading to variably pruritic, hyperpigmented-to-erythematous patches and plaques. Characteristic histopathologic features include a thickened stratum corneum, compact parakeratosis with retention of keratohyalin granules, vascular proliferation, and ectasia. The pathogenesis of this entity is uncertain.

METHODS

We present a case of axillary granular parakeratosis and review the literature.

RESULTS

The lesion showed a thickened stratum corneum with compact parakeratosis, slight epidermal hyperplasia, and a sparse perivascular lymphohistiocytic infiltrate. Keratohyalin granules were diffusely present within the parakeratotic stratum corneum, and the retained granular layer showed focal vacuolization.

CONCLUSIONS

Granular parakeratosis is a rare form of parakeratosis most often seen in the axilla, although other intertriginous areas may be affected. Unique histopathologic findings allow for a specific diagnosis to be made. Although an irritant contact reaction appears causative, mechanical irritation may also play a role in inducing these skin changes.

Occurrence of patchy parakeratosis in normal-appearing skin in patients with active atopic dermatitis and in patients with healed atopic dermatitis: a cause of impaired barrier function of the atopic skin

It remains unclear whether an impaired barrier function often seen in areas of normal-appearing skin in patients with active atopic dermatitis (AD) is primary event in nature or secondary to subclinical eczematous change. We then attempted to evaluate the barrier function of normal-appearing skin in both active and healed AD patients, and as well as see whether a subclinical eczematous change exists or not in the normal-appearing skin using a non-invasive method. Transepidermal water loss (TEWL) measurement and exfoliative cytology method for corneal layer were applied in 153 AD patients who have active skin lesions and 29 individuals with completely healed AD for at least 5 years and 40 normal individuals. The TEWL of normal-appearing skin in severe, moderate and mild AD cases was 10.5+/-2.9, 8.3+/-2.4 and 7.3+/-2.1 g/m2 per h, respectively. The TEWL values in severe and moderate cases were significantly higher than the normal controls (6.2+/-1.6 g/m2 per h). However, the TEWL was not deranged in patients with completely healed AD. An exfoliative cytology examination of corneal layer disclosed that patchy parakeratosis appeared in normal-appearing skin in severe, moderate and mild AD cases at a rate of 42, 29 and 19%, respectively. However, no patchy parakeratosis was recognized in patients with completely healed AD. The occurrence of patchy parakeratosis in normal-appearing skin in patients with active AD suggests that an impaired barrier function often seen in normal-appearing skin in AD patients is secondary to subclinical eczematous change in the area.

Citrus pulp for cattle

Citrus pulp is classified as an energy concentrate by-product feed. Citrus by-products fed to beef cattle include citrus molasses, citrus meal, wet citrus pulp, dried citrus pulp, and pelleted citrus pulp; however, in current production systems, pulp (wet, dry, and pelleted) is the only by-product commonly used. Citrus pulp production in the United States is limited to specific subtropical regions, of which south central Florida remains the largest with additional production in California and Texas.

Impact of global genome repair versus transcription-coupled repair on ultraviolet carcinogenesis in hairless mice

The nucleotide excision repair (NER) system is comprised of two subpathways, i.e., transcription-coupled repair (TCR) and global genome repair (GGR). To establish the relative importance of TCR and GGR for UV effects on the skin, we have used hairless knockout mouse strain lacking either TCR (CSB -/-) or GGR (XPC -/-). In single exposure experiments, we found that CSB -/- mice have a 7-16 times higher susceptibility to sunburn than XPC -/- mice and than heterozygous (+/-) and wild-type (+/+) controls. Exposure to 80 J/m2 UV radiation (i.e., suberythemogenic in CSB -/-) on 10 consecutive days gives rise to epidermal hyperplasia in CSB -/- and XPC -/-, whereas repair-proficient controls do not show epidermal hyperplasia from these exposures. In addition, CSB -/- mice develop marked parakeratosis, whereas XPC -/- mice and controls do not. Under continued exposure to this daily dose, squamous cell carcinomas appear in CSB -/-, XPC -/-, and in the control groups, whereas only in the CSB -/- animals is a fairly high number of benign papillomas also found. The median latency time of squamous cell carcinomas (diameters > or = 1 mm) is 84 days for the XPC -/- mice, 115 days for the CSB -/- mice, and 234-238 days for the heterozygous and wild-type control groups. These results indicate that GGR is more important than TCR in protection against UV-induced carcinomas of the skin but not against other UV effects such as sunburn, epidermal thickening, scaling of the stratum corneum, and development of papillomas. These results also indicate that GGR capacity may serve as a better predictor for skin cancer susceptibility than sensitivity to sunburn. The relative cancer susceptibilities of GGR- and TCR-deficient skin could well depend on the balance between an increased mutation rate and the presence (in CSB -/-) or lack (in XPC -/-) of a compensatory apoptotic response.

Epidermal changes in cutaneous lesions of sarcoidosis

The essential histologic finding of cutaneous sarcoidosis is a noncaseating epithelioid cell granuloma in the dermis or, infrequently, in the subcutaneous tissues. However, there have been cases of cutaneous sarcoidosis with clinical appearances altered by epidermal changes such as ulcers, the formation of psoriasiform or verrucous plaques, and by hypopigmentation. In this study, histologic examinations of the epidermis were performed in cutaneous lesions of 62 cases of sarcoidosis. Seventy-nine percent (49/62) showed epidermal changes including hyperkeratosis (8/49), parakeratosis (10/49), acanthosis (6/49), and epidermal atrophy (35/49). Lymphoid cells extended into the epidermis in 50 of 62 cases. The infiltration patterns were in the forms of a spongiotic reaction (21/50), lichenoid tissue reaction (9/50), and simple exocytosis without epidermal vesiculation (20/50). Immunohistochemical studies showed that the lymphoid cells in the epidermis expressed CD3, 8, 45RO, and 11a. The epidermal changes overlying the granulomatous lesions contribute to the variety of clinical manifestations and are in part associated with the pathogenesis of cutaneous sarcoidosis.

Submammary granular parakeratosis: an acquired punctate hyperkeratosis of exogenic origin

Granular parakeratosis is a histologic phenomenon that produces a characteristic clinical picture with multiple brownish and hyperkeratotic papules. In all 6 published cases of localized axillary parakeratosis, excessive use of different topical preparations (cream-type products, deodorants that include roll-on and stick types, antiperspirants, shampoos, bath soaps) was reported by the authors. The exact pathogenic causal relationships have not yet been resolved. In the case reported below, we demonstrate for the first time that the macro- and micromorphological entities can also occur in the submammary region.

Methods for exposure of laboratory animals to ultraviolet radiation

Two different sources of ultraviolet B (UVB) radiation, an electronically controlled UVB exposure unit, containing FS40 tubes, and a hand-held Kromayer lamp, were evaluated for actual irradiance in W/m2 and spectra (physical dosimetry and biological dosimetry (skin effects in rodents)). The technical studies of the FS40 sources demonstrated that the flux intensity of the lamps could be changed electronically, without affecting the spectrum. Thus it was possible to standardize UVB exposure electronically. The biologically effective doses of these sources were analysed in RIV-Tox Wistar rats and BALB/c mice. After low doses of UVB radiation, histopathological changes such as acanthosis, hyperkeratosis and dermal inflammation were observed in the skin without the presence of major side effects such as erythema and oedema. After higher doses of UVB radiation erythema and oedema were clearly visible. Quantitative studies showed that the minimal erythema dose, as a biological parameter, correlated well to the emission in J/m2. In addition, biological parameters such as acanthosis and inflammation in the skin correlated well to the actual exposure in J/m2 and were sensitive biomarkers for UVB-induced skin toxicity. Thus, in addition to minimal erythemal doses, acanthosis and inflammation may also be applied as biologically relevant doses for studies of the biological effects of UVB radiation.

[Symptoms and course of a parakeratosis outbreak in a boar raising facility]

A case of parakeratosis in pigs due to secondary zinc deficiency (zinc/calcium ratio 0.4 g/100 g; 68.7 mg zinc, 17.1 g calcium per kg food) is reported. Morbidity and symptoms were much more marked in growing boars than in female animals of the same age. In sows the disorder appeared ten days after the first symptoms were seen in the boars. Adult breeding pigs developed no signs of parakeratosis.

Axillary granular parakeratosis

The term axillary granular parakeratosis is proposed for a unique axillary eruption with distinct histopathologic features. Four middle-aged to elderly patients (three women, one man) had unilateral or bilateral, usually pruritic, hyperpigmented to bright red patches in the axillae. Biopsy specimens revealed severe compact parakeratosis with the stratum corneum measuring 80 to 250 microns in maximal thickness, maintenance of the stratum granulosum, remarkable retention of keratohyaline granules throughout the stratum corneum, and vascular proliferation and ectasia. A contact reaction to an antiperspirant/deodorant is suspected as the cause. We speculate that the offending agent alters the maturation sequence of the stratum granulosum and stratum corneum, possibly by interfering with the degradation of filaggrin precursor to filaggrin units.

Rate of development of oesophagogastric parakeratosis in the growing pig: some effects of finely ground barley diets, genotype and previous husbandry

The rate of development of parakeratotic lesions in the gastric pars oesophagea was investigated in three experiments using 360 pigs, initially aged 10 to 11 weeks and weighing about 30 kg, of differing genotype and with some differences in previous rearing method, given a diet based on finely ground barley which was known to predispose to lesion formation. Lesions were found in some pigs at 10 to 11 weeks old but the incidence and severity increased progressively indicating development as quickly as one month after first giving the finely ground diet. There were indications that different genotypes and different diets given previously in rearing may have influenced the results obtained. The possible influence of other environmental factors is discussed.

Oesophagogastric parakeratosis in the growing pig: effects of the physical form of barley-based diets and added fibre

In four experiments a total of 288 individually fed pigs were given barley-based diets for about 100 days from about 20 kg liveweight. Fine grinding of barley increased the number and severity of oesophagogastric lesions. Pelleting a diet based on coarsely ground barley had a similar effect. Coarser grinding of the barley and substituting small proportions of oat husk, but not of bran, gave lower incidences and severities of lesions. The performance responses of the pigs differed and give a framework for deciding on the balance to be struck between optimal performance and the risk of lesion development.

Neonatal citrullinemia associated with cutaneous manifestations and arginine deficiency

A patient with neonatal citrullinemia (argininosuccinic acid synthetase deficiency), a heritable disorder of the urea cycle, developed a generalized cutaneous eruption at 35 days of age. The skin lesions consisted of erosive, erythematous, scaling patches and plaques. The plasma arginine concentration at that time was low. After treatment with oral arginine supplements, the cutaneous lesions rapidly resolved and the plasma arginine concentration normalized. Histologic features of pretreated lesions included parakeratosis, crust formation, absence of a granular cell layer, pallor of the upper epidermal cells, and a mild, superficial, perivascular, mononuclear-cell infiltrate. Since the patient's skin lesions responded to arginine supplements, and since arginine is a component of keratin, we postulate that the skin lesions are the result of arginine deficiency.

Zinc requirement of the baby pig when fed wet-autoclaved spray-dried egg albumen as the protein source

Pigs 16 d of age were allotted to eight dietary levels of total zinc (6-36 ppm in 5 ppm increments and 116 ppm) in a 28-d experiment designed to reevaluate the zinc requirement of the neonatal pig. The basal 21.0% crude protein diet contained wet-autoclaved spray-dried egg albumen (WAEA) as the protein source. Dietary zinc level did not affect (P greater than 0.05) pig growth for the first 14 d of the experiment. Pig growth was adequate from d 14 to 28 of the experiment with 11 ppm or more of zinc. The milligrams of zinc retained per day per pig increased (P less than 0.05) with increasing dietary zinc up to 26 ppm, plateaued from 26 to 36 ppm and declined (P less than 0.05) at 116 ppm. Plasma zinc levels were higher (P less than 0.05) for pigs fed 31 ppm or more of zinc compared with 16 ppm or less of zinc on d 21 and 28. Tibia and femur concentrations of zinc also increased with increasing dietary zinc up to 26 ppm. Esophageal tissue was normal in the majority of pigs fed 31 ppm or more of zinc. Retention of 65Zn further suggested that diets containing 26 ppm or less zinc were deficient in this element. Thus, zinc balance, concentrations of zinc in plasma and bone, esophageal histology and retention of 65Zn indicate that the minimum zinc requirement of the neonatal pig is between 26 and 31 ppm when fed a purified diet devoid of phytate.

Domestic animals in the elucidation of zinc's role in nutrition

Parakeratosis in swine, a disease that caused severe economic losses in many commercial herds during the late 1940's and early 1950's, was caused by an inadequate intake of zinc. In addition to poor growth, the disease involves primarily the epidermal layer of the skin, which in severe cases becomes thickened and heavily encrusted. Finally, deep fissures develop in the encrusted areas. The low availability of zinc in plant protein sources and the increasing use of soybean meal in practical-type diets during the late 1940's contributed to the increasing incidence of the disease. Excessive levels of calcium also increased the incidence and severity of the disease. Prominent features of zinc deficiency in poultry were failure of normal development of long bones and the occurrence of severe lesions on the feet and legs. As with the pig, the low bioavailability of zinc from plant protein sources led to the observation that practical-type diets were limiting in this metal. Although parakeratosis can be produced in cattle fed diets low in zinc, it does not seem to have been a major nutritional problem in ruminants.

[Exogenous zinc deficiency syndrome]

Two cases of acquired zinc deficiency after excessive bowel resection and total pancreatectomy and after total parenteral nutrition are reported. Skin lesions include diffuse hair loss and a psoriasis like dermatitis localized mainly at acral areas and around body orifices, which disappeared rapidly after oral supplementation of zinc sulfate. Clinical symptoms, etiological factors, differential diagnosis and therapy are discussed.

Heck's disease (focal epithelial hyperplasia)

A patient and his mother noted the insidious appearance of a distinctive benign papular eruption confined to the mucosa of the lips. The clinical pattern and histologic findings fulfill the criteria of a recently described entity, focal epithelial hyperplasia. An electron microscopic search for viral particles was negative. Arguments for both a viral and a hereditary pathogenesis have been put forth, but the etiology of the condition remains controversial. This disorder may be more frequently reported as dermatologists become increasingly aware of its existence.

Lichen nitidus of the palms

A case is presented of lichen nitidus that evolved into an acquired palmar keratoderma in a fifty year old woman; this is a rare manifestation of the disease. Lichen nitidus must be considered in the differential diagnosis of keratoderma palmaris.

The effects of feeding a zinc-deficient diet on taste acuity and tongue epithelium in rats

Taste preferences, fluid intake and histology of tongue epithelium were studied in rats fed a zinc-deficient diet and in pair-fed controls. The results of two-bottle preference tests demonstrated that zinc-deficient rats exhibited significantly increased preferences for 1.5 X 10(-1) M HCL and 1.28 X 10(-6) M quinine sulfate as well as a significant increase in relative fluid volume intake. Histologic examination of the tongue epithelium of the zinc-deficient rats showed a hypercellular prickle cell layer and a marked parakeratosis. The fungiform papillae of the zinc-deficient rats exhibited acanthosis and mild parakeratosis. However, the pore region of the taste buds did not seem to be covered by the parakeratotic epithelium. The results suggest that the impaired taste observed in zinc-deficient rats may not be related to blockage of tastants from the pore region.

[Acrodermatitis enteropathica--zinc as a life-saving drug]

Formerly acrodermatitis enteropathica was treated with oxiquinoline without full control of the disease and with the danger of blindness. Moynahan has introduced zinc into the treatment with excellent results, based on the finding that acrodermatitis enteropathica is a zinc-deficiency disorder. Other authors and own observations have confirmed the findings of Moynahan. There are clinical, genetical, immunological and therapeutical parallels between the acrodermatitis enteropathica of man and the so-called hereditary parakeratosis of calves which also is a hereditary disturbance of zinc metabolism. The treatment of acrodermatitis enteropathica with zinc is furthermore a great success in the prevention of blindness, as zinc is not dangerous to the retina and the optic nerve.