Subcutaneous pheohyphomycotic cyst from a traumatic injury: reactivation after thirty-five years.

Pheohyphomycoses are an uncommon diverse group of dematiaceous fungi present in soil and plant material and are potential pathogens. We report the case of a 45-year-old white Hispanic woman who presented with a hard round cyst on the dorsum of her right foot caused by a traumatic implantation of a piece of wood thirty-five years earlier. The cyst was surgically excised and the patient empirically treated with a two-month course of oral itraconazole. To our knowledge, this represents a case of the longest-lived asymptomatic pheohyphomycotic cyst in an immunocompetent person ever reported. The clinical manifestations, treatment options, and disease course are reviewed.

The relationship between basal cell epithelioma and seborrheic keratosis. A study of 60 cases.

BACKGROUND: Various skin tumors can be seen rarely in association with seborrheic keratosis. We present 60 cases of seborrheic keratosis related to a basal cell epithelioma in the same specimen. OBJECTIVE: To report association of basal cell epithelioma with seborrheic keratosis and discuss the possibility of malignant change in seborrheic keratosis. METHODS: Sixty cases of seborrheic keratosis associated with basal cell epithelioma were studied. Tissues were fixed in neutral buffered formalin, processed, and stained with standard hematoxylin and eosin techniques. RESULTS: Histological evaluation showed a seborrheic keratosis associated with basal cell epithelioma in all of the cases. Basal cell epithelioma was attached with seborrheic keratosis in a majority of the cases (40/60) and appeared to represent a part of the same tumor. Both tumors were lying adjacent to each other in the rest of the cases (20/60). CONCLUSION: Malignant change in seborrheic keratosis is controversial. We recommend the histological evaluation of seborrheic keratosis especially when inflamed or atypical in appearance. This should not be taken as a mandate for pathological evaluation or for treatment of every seborrheic keratosis as though it was potentially malignant.

Notalgia paresthetica. Case reports and histologic appraisal.

Notalgia paresthetica, literally an abnormal sensation of the back, is not a well-known entity in the medical community. However, we have recently studied 14 cases that have demonstrated relatively uniform clinical and histopathologic features. To our knowledge the latter of these have not been described previously. We believe it is important to familiarize the clinician with this relatively common entity.

Reticulated porokeratosis. A unique variant of porokeratosis.

A young man presented with a chronic, persistent reticulated dermatosis involving the groin, genitals, and thighs that was refractory to therapy. Biopsy specimen revealed multiple cornoid lamellae consistent with porokeratosis. This clinical appearance has not been previously described, to our knowledge. The other clinical forms of porokeratosis and their histology are briefly reviewed.

Isolation of Legionella pneumophila serogroup 1 from blood with nonsupplemented blood culture bottles.

Legionella pneumophila serogroup 1 was isolated from antemortem aerobic blood culture bottles not supplemented with L-cysteine or ferric pyrophosphate and from the postmortem lung tissue of a 72-year-old man. We recommend that aerobic blood culture bottles (Johnston Laboratories, Cockeysville, Md.) of BACTEC be subcultured to an agar that supports the growth of L. pneumophila when growth indexes range from 30 to 60 but fail to increase further.

Rapid presumptive identification of vibrios by immobilization in distilled water.

Each of 28 Vibrio strains and 3 Campylobacter strains was immobilized in distilled water (pH 6.9), but retained full motility in Trypticase soy broth. This phenomenon was not seen with any of 243 non-Vibrio, non-Campylobacter isolates representing 44 taxa of gram-negative bacteria.