[From hedgehogs to men. Zoophilic dermatophytosis caused by Trichophyton erinacei in eight patients]. / Von Igeln auf Menschen. Zoophile Dermatomykose durch Trichophyton erinacei bei 8 Patienten.

The hedgehog is an in Germany previously unrecognized source of human ringworm. Eight hedgehog caretakers from Göttingen and the surrounding area developed dermatophytosis caused by Trichophyton erinacei. Four patients who handled the animals without gloves developed lesions on the hands that were more in keeping with hand eczema, leading to a delay in diagnosis. The other caretakers who wore gloves presented with typical ringworm on the arms, the big toe, the back, the abdomen, and the thighs. Their typical clinical features led to an early diagnosis and treatment.

[Black nails caused by Proteus mirabilis]. / Ungues nigri durch Proteus mirabilis.

Black nails caused by Proteus mirabilis were seen in a motor mechanic and in a petrol pump attendant. Proteus mirabilis is a gram-negative bacillus that generates hydrogen sulfide. This compound reacts with traces of metals in the nail plate such as zinc, nickel, cobalt, iron, manganese, tin, copper and lead. Metal sulfides blacken the nail plate. The protracted course of the discoloration over months corresponds to the slow reactions of metals with hydrogen sulfide. The disappearance of the blackening after topical treatment with chinosol, tincture of iodine and chloramphenicol solution supports the etiologic connection between black nails and Proteus mirabilis. Wet and dirty work encourages the colonisation of Proteus mirabilis between nail fold and nail plate.

[Diagnosis, clinical aspects and therapy of early chromoblastomycosis in a case example]. / Diagnostik, Klinik und Therapie der frühen Chromoblastomykose an einem Fallbeispiel.

Despite the availability of modern antimycotics, which produce high cure rates in early infections, the therapy of advanced chromoblastomycosis is still unsatisfactory. An initial chromoblastomycosis caused by a hitherto unidentified species of the genus Phialophora was diagnosed in a 46-year-old teacher. The organism was isolated twice at an interval of 6 weeks from a partly psoriasiform, partly verrucous lesion on the 4th toe. The infection was apparently acquired 4 years ago during a holiday at Cape Verde. Treatment with itraconazole (Sempera). 200 mg/day, and amphotericin B (Ampho-Moronal) cream for 6 weeks initially resulted in rapid regression. However, 4 weeks after cessation of therapy, the Phialophora species was cultured again from skin scrapings. Complete healing was achieved after re-treatment with itraconazole for 20 weeks at the same dosage in combination with topical amorolfine and local hyperthermia. Until now, no relapse has occurred. The present case demonstrates that this rare disease, which mainly occurs as a traumatic mycosis in the rural population of tropical regions, must be included in the differential diagnosis of psoriasiform or verrucous skin lesions and also included in the list of diseases which may be acquired while on vacation in exotic locations.

[The lipolytic activity of dermatophytes]. / Die lipolytische Aktivität von Dermatophyten.

Dermatophytes are able to crack the fatty acid molecule of polyoxyethylensorbitan monolaurate (Tween 20), polyoxyethylensorbitan monopalmitate (Tween 40), polyoxyethylensorbitan monostearate (Tween 60), and polyoxyethylensorbitan monooleate (Tween 80). The hydrolysis of this medium occurs due to lipolytical enzymes of dermatophytes. The liberated fatty acids bind up the calcium, which is added in the medium. They are visible as insoluble crystals around the colonies.

[Current status of the therapy of granulomatous skin infections]. / Derzeitiger Stand der Therapie granulomatöser Hautinfektionen.

We report on granulomatous infections of the skin, as well as the current state of therapeutics. Cutaneous tuberculosis and presently desired therapeutic regiments are treated in detail. Diseases regarded as eradicated in Germany, such as brucellosis and listeriosis, do still occur. Their recognition and cure are discussed from a modern point of view.

[Diseases caused by atypical mycobacterial]. / Erkrankungen durch atypische Mykobakterien.

Infections having atypical mycobacteria are occurring more frequently for 2 main reasons. First there are the disturbances of the immunity system, whether due to the acquired immune deficiency syndrome (AIDS) or the result of therapeutic measures taken against malignant processes, other diseases or after organ transplantation. Second, travel and free-time activities increase the risk of an infection. In many cases such infections become localized on the skin, but can also develop changes in the lungs, depending on the patient's occupation. For this reason we provide a review of the new literature on the microbiology of mycobacteria as well as on the symptoms of diseases of the skin and other organs which are caused by atypical mycobacteria, such as swimming pool granuloma or Buruli ulcer.

[Occupational koilonychia]. / Berufsbedingte Koilonychie.

Over a period of 10 years a 57-year-old patient mainly repairing oil-burner gradually developed spoon-like deformations of his finger nails. A 47-year-old patient observed similar alterations working as a butcher for 4 years. We want to stress the occupational induction of the disease and its therapeutical consequences.

[On the local efficacy of ciclopiroxolamine in onychomycoses (author's transl)]. / Zur Lokalwirksamkeit von Ciclopiroxolamin bei Nagelmykosen.

An open, multicenter clinical trial of 6-cyclohexyl-1-hydroxy-4-methyl-2(1H)-pyridone, 2-aminoethanol salt (ciclopiroxolamine, Cic, Hoe 296, Batrafen) was performed in 150 patients with 246 nails afflicted by mycotic infection. Dermatophytes were observed in 96% of the initial cultures. A combination of 1% Cic solution and cream was applied, and a very strict nail toilet was performed. The mean duration of study was 12.7 +/- 5.6 weeks, followed by a 6 week follow-up period on the average. The share of pathologically changed nails of 35 +/- 16% was reduced to 8 +/- 10% of nail plate. In a total of 96% of patients, some of whom had only been treated for a brief period, a measurable improvement was observed, and 57% of the patients were free from signs of infection. Signs of intolerance or definite relapses were not observed.