ABSTRACT
BACKGROUND: Cutaneous T-cell lymphoma (CTCL) encompasses a broad range of lymphoproliferative diseases affecting the skin and can be clinically misleading due to its variable presentation. Nail alterations commonly appear in advanced-stage mycosis fungoides and true Sézary syndrome; however, they may be present in any stage of the disease. Although proper recognition of nail involvement in CTCL has both clinical and therapeutic value, specific nail findings have been infrequently described in the current literature. OBSERVATIONS: We describe 4 patients with CTCL who presented with clinically significant nail alterations. The most common findings were nail discoloration, thickening, crumbling, onycholysis, and onychomadesis. Other notable findings included splinter hemorrhages, subungual hyperkeratosis, and anonychia. CONCLUSIONS AND MESSAGE: The described cases illustrate many of the documented nail findings associated with CTCL and emphasize the variable nature of nail manifestations. The presence of specific nail alterations should increase the clinical suspicion of CTCL - especially in patients with concomitant systemic and/or cutaneous manifestations - and early biopsy specimens should be taken for diagnosis. Nail alterations should also be accurately described and monitored in all patients with biopsy-confirmed CTCL to help identify treatment response and detect disease recurrence.
ABSTRACT
Urban runoff contributes significant amounts of heavy metals into receiving waters in which turtles make up a large portion of the biodiversity. Turtles accumulate heavy metals in their body and shell bone, yet little is known about how it affects their health. Studies in vertebrates have shown bioaccumulation of lead to have several deleterious effects such as immunosuppression, impairment of skeletal calcification and competition with calcium ion uptake. This study surveys the bioaccumulation of lead in emydid turtles of an urban lake and investigates the differences based on species, sex, size and its possible relationship to shell disease. Shell disease was quantified and small sections of shell were collected from each specimen and analyzed for lead content using Graphite Furnace Atomic Adsorption Spectrometry. Significant differences of lead accumulation were found between species, yet not with sex or body size. Linear regression comparison of lead concentration and shell disease showed no positive correlation.
