Basal cell carcinoma of the nail unit: a case report.

Basal cell carcinomas (BCC) of the foot are rare. A review of the English literature found only 23 cases of BCC reported in the foot, none of which involved the nail unit. The nail unit, which is composed of the nail bed and nail-folds, is an exceedingly atypical site for basal cell carcinomas. A case of BCC of the proximal nail fold of the hallux which was treated with Mohs Micrographic Surgery (MMS) is presented.

Topical cyclosporine administration in rabbits.

Cyclosporine (CyA) is a potent immunosuppressant, but possesses toxicities which prohibit its unrestricted dosing in patients. The topical administration of CyA could serve to localize the immunosuppressive effect, or could serve as an administration route for patients who cannot tolerate the oral route of administration. We evaluated the potential for transdermal delivery of cyclosporine in rabbits. We sensitized six rabbits to dinitrochlorobenzene (DNCB), treated them topically with either 100 mg CyA or the vehicle, and repeated the DNCB skin testing at 15 and 28 days at the site of administration and at a distal site. In the CyA treated rabbits, significant increases in the suppression of the reaction to DNCB were observed from the control to the 15 day test, and from the 15 to the 28 day testing. Significant differences were also observed between reaction to DNCB at the site of CyA administration and at the distal site. While blood concentrations demonstrated slow and variable absorption of the topically administered CyA, concentrations greater than 1000 ng/ml were frequently observed in blood. We conclude that the local versus a systemic dermatologic effect of CyA can be achieved, and that high blood concentrations are present after topical CyA administration in this model.

Clinical manifestations of intrathoracic cutaneous T-cell lymphoma.

Intrathoracic involvement with cutaneous T-cell lymphoma (CTCL) was documented in eight patients with mycosis fungoides and two patients with Sezary syndrome. The radiographic findings consisted of multiple bilateral parenchymal nodular densities (five patients), patchy areas of consolidation (two patients), diffuse reticulonodular or interstitial infiltration (two patients), and pleural effusion without underlying parenchymal disease (one patient). Dyspnea on exertion and nonproductive cough were the most frequent presenting symptoms, and physical examination of the lungs was usually normal. In one patient a partial Pancoast's syndrome developed from a pulmonary apical mass. Results of blood gas studies and pulmonary function tests indicated an alveolar-capillary block in gas diffusion. Although the antemortem diagnosis was often suggested on cytopathologic preparations or on tissue obtained by transbronchial or percutaneous needle aspiration biopsy, a definitive diagnosis of CTCL usually required an open-lung biopsy. The response of pulmonary infiltrates to various systemic chemotherapeutic agents was variable, and the mean survival after initiation of drug therapy was 9.5 months. The findings suggest that combined modality therapy should be considered for patients with extracutaneous CTCL.