Subungual squamous cell carcinoma masquerading as a melanotic macule.

Subungual squamous cell carcinoma is a rare condition. Diagnosis is often delayed because it presents with minimal nail changes and mimics a number of benign nail conditions. We report a 43-year-old Chinese man who presented with a three-year history of an indolent melanotic macule of the fingernail. Histology from a punch biopsy revealed a well-differentiated squamous cell carcinoma. Wide local excision with full thickness skin grafting was performed. Physicians should have a high index of clinical suspicion as early nail biopsy and prompt tumour clearance can preserve joint function.

Lichen amyloidosis in an unusual location.

We report lichen amyloidosis occurring on the upper lip and nasolabial folds of a 61-year-old woman from Singapore. She had a past history of systemic lupus erythematosus, which was in remission for three years. There had been no lesions of lupus erythematosus in this area. Clinically, the lesions were skin-coloured, firm papules and our differential diagnoses included trichoepithelioma, papular sarcoid or lupus miliaris disseminatus faciei. Skin biopsy from one of the lesions showed amyloid deposits in the dermis which were Congo red stain positive. These deposits also showed apple green birefringence. Immunohistochemical staining of the amyloid deposits stained positive for cytokeratins (CK) 5 and 6, and negative for CK 14. The kappa and lambda stains were equivocal. Further investigations, including multiple myeloma screen and rectal biopsy, ruled out systemic amyloidosis. There was no other evidence of cutaneous amyloidosis on her limbs or trunk. She refused treatment for her lesions. This case highlights the commonly-seen form of primary localised cutaneous amyloidosis in an unusual location.

Cutaneous injuries from marine animals.

Cutaneous injuries by marine animals have a myriad of clinical presentations. Most require only symptomatic treatment, but some may be limb-threatening or even fatal. This is a report of three cases of marine animal injuries by a stingray, a sea anemone and a jellyfish, respectively, illustrating the potential severity of such injuries. The importance of early diagnosis is emphasised, with a discussion on the management of injuries from these three types of marine animals.

Megaselia scalaris (Diptera: Phoridae) can live on ripe bananas--a potential health hazard?

OBJECTIVE: Identification of larvae that inest bananas and investigating its habits. DESIGN: Laboratory based study. SETTING: Department of Parasitology, Faculty of Medicine, University of Colombo. METHODS: Bananas brought to the department with a query of maggot infestation were examined and the presence of maggots was confirmed. Maggots were allowed to develop into adults. The larvae and the flies were identified using standard keys. RESULTS: Megaselia scalaris was identified, the larvae of which infest ripe bananas. Three generations of M scalaris were reared using ripe bananas as the only source of food. Two other banana specimens yielded larvae that eventually grew into adult flies of Bactrocera species. CONCLUSIONS: In addition to Bactrocera spp. larvae of which are known pests in bananas, M scalaris larvae were detected as pests for the first time. We demonstrated that M scalaris can complete its life-cycle depending on ripe bananas as the only source of food. The vast consumption of bananas and the potential of M scalaris to cause intestinal and wound myiasis in humans make these findings medically important.