ABSTRACT
Hyperpigmentation of the fingernails can occur during therapy with doxorubicin (Adriamycin). Two patterns are common: diffuse, and transversely banded. The pigment is believed to be melanin, and both patterns disappeared with discontinuation of therapy and subsequent nail growth.
Subject(s)
Doxorubicin/adverse effects , Nail Diseases/chemically induced , Pigmentation Disorders/chemically induced , Adolescent , Child , Humans , Male , Nail Diseases/pathology , Pigmentation Disorders/pathologyABSTRACT
Three patients with herpetic whitlow are presented. Virus typing revealed herpes simplex virus type 1 in two and type 2 in one of the cases. There is a high risk of infection among medical personnel.
Subject(s)
Fingers , Hand Dermatoses/microbiology , Health Occupations , Herpes Simplex/microbiology , Occupational Diseases/microbiology , Simplexvirus/isolation & purification , Adult , Female , Finger Injuries/complications , Hand Dermatoses/etiology , Herpes Simplex/etiology , Humans , Male , Occupational Diseases/etiology , Thumb/injuriesABSTRACT
A 42-year-old male was hemodialyzed for 2 years with excellent control of calcium-phosphate metabolism. He received a cadaveric renal transplant but experienced a prolonged episode of acute tubular necrosis during which he could not tolerate phosphate-binding antacids. His calcium X phosphate product became markedly elevated for 20 days. Following a brief period of function, the homograft was removed on the 45th post-transplant day after severe rejection and subsequent infection. Chest X-ray was normal. Six days after graft nephrectomy, he became acutely dyspneic and markedly hypoxemic. Diffuse, flocculent pulmonary infiltrates appeared on the chest film. The patient expired 1 day later. At postmortem examination, there was severe, diffuse pulmonary alveolar calcification demonstrated by chemical and histologic examination. Although unlikely, the prolonged post-transplant period characterized by elevated calcium X phosphate product may have played a pathogenetic role. Calciphylaxis may have occurred, with hyperparathyroidism as the sensitizing agent and any of several drugs acting as challenger.
