Point-of-Care Diagnosis of Onychomycosis by Dermoscopy.

Background: Onychomycosis is one of the most common diseases of the toenails. The costs of diagnosis and treatment are substantial, and as the population ages, the overall cost burden will continue to escalate. The purpose of this study was to correlate dermoscopic features with pathologic diagnosis to support the accuracy of point-of-care diagnosis by dermoscopic examination.

Kyrle Disease A Rare Dermatologic Condition Associated with the Diabetic Foot.

We report two cases of biopsy-confirmed Kyrle disease. Kyrle disease is one of the perforating dermatoses associated with diabetic patients undergoing renal dialysis. In this report, we describe the clinical and histopathologic features, the differential diagnoses, and successful treatment of this unusual disorder.

The microbiologic spectrum of dacryocystitis: a national study of acute versus chronic infection.

Purpose: To examine the microbiologic spectrum of dacryocystitis, specifically characterizing differences between acute and chronic infection.

Methods: National multicenter prospective study of the microbiologic spectrum of acute and chronic dacryocystitis based on culture results reported between March 2005 and March 2006. Chi-square analysis was used to compare differences between groups.

Induction of IL-6 expression by mechanical stress in the trabecular meshwork.

The trabecular meshwork (TM)/Schlemm's canal (SC) outflow pathway is the tissue responsible for maintaining normal levels of intraocular pressure. In the present study, we investigate the effects of mechanical stress on the expression of IL-6 in the TM meshwork, as well as the effects of this cytokine on outflow pathway function. Application of cyclic mechanical stress to human TM primary cultures resulted in a statistically significant increase in both secretion and transcription of IL-6, compared to nonstressed controls.

Nail dystrophies.

Various individual nail dystrophies that are not easily categorized within other articles are reviewed. Onychoatrophia, anonychia, onychorrhexsis, leukonychia, Beau's lines, onycholysis, onychomadesis, onychoschizia, haplonychia, longitudinal melanonychia, and ventral pterygium are included and clinically pictured. Their clinical description, etiology, associated conditions, differential diagnoses, and treatment are discussed and tabulated.

Satisfaction with onychomycosis treatment. Pulse versus continuous dosing.

The purpose of this study, which involved two dermatology clinics and two podiatric medical clinics, was to determine whether a difference exists in patient-reported satisfaction and compliance between continuous terbinafine therapy and pulse-dose itraconazole therapy for the treatment of toenail onychomycosis. Patients in this multicenter, open-label, cross-sectional study had previously completed treatment with either oral terbinafine or oral itraconazole for toenail onychomycosis. Patients were interviewed by telephone to assess clinical outcomes, compliance, and satisfaction with treatment; clinical data were collected by medical chart review.

Topical treatments for onychomycosis: a historical perspective.

Topical treatment of onychomycosis, in contrast to systemic oral therapy, allows the patient to apply medication directly to the affected area, thereby decreasing the potential for adverse events and drug interactions. Historically, several topical antifungal agents have been used in the treatment of onychomycosis; however, the evidence for their effectiveness is based on very limited data or anecdotal reports. Recently, the development of new, effective topical agents has renewed interest in this form of therapy.

Synthesis and biological evaluation of prostaglandin-F alkylphosphinic acid derivatives as bone anabolic agents for the treatment of osteoporosis.

A series of novel C(1) alkylphosphinic acid analogues of the prostaglandin-F family have been evaluated at the eight human prostaglandin receptors for potential use in the treatment of osteoporosis. Using molecular modeling as a tool for structure-based drug design, we have discovered that the phosphinic acid moiety (P(O)(OH)R) behaves as an isostere for the C(1) carboxylic acid in the human prostaglandin FP binding assay in vitro and possesses enhanced hFP receptor selectivity when compared to the parent carboxylic acid. When evaluated in vivo, the methyl phosphinic acid analogue (4b) produced a bone anabolic response in rats, returning bone mineral volume (BMV) [corrected], to intact levels in the distal femur in the ovariectomized rat (OVX) model.

Medium-chain acyl coenzyme A dehydrogenase deficiency: occurrence in an infant and his father.

Background: Autosomal recessive inborn errors of metabolism often present as life-threatening disease in infancy and have adverse effects on the nervous system. Parents are usually heterozygotes. This is true of most disorders of fatty acid oxidation, which are rare and present with hypoketotic hypoglycemia.

Superficial white onychomycosis.

A study on the incidence and causative organisms of pedal superficial white onychomycosis within several patient populations is presented. Early recognition, debridement, and topical antifungal therapy for several weeks with attention to biomechanical factors should resolve the infection and prevent progression to a more destructive form of onychomycosis.

Miscellaneous nail presentations.

A variety of individual nail dystrophies that are not categorized easily in other articles are reviewed. Onychoatrophia, anonychia, onychorrhexis, leukonychia, Beau's lines, onycholysis, onychomadesis, onychoschizia, haplonychia, longitudinal melanonychia, and ventral pterygium are included and pictured clinically. Their clinical description, etiology, associated conditions, differential diagnoses, and treatments are discussed and tabulated.

Interleukin-1 pretreatment prevents interleukin-1-induced lung leak in rats.

We found that rats pretreated with interleukin-1 (IL-1) intraperitoneally did not develop the acute oxidative, neutrophil-dependent lung leak that occurs after administration of IL-1 intratracheally (IL-1-induced tolerance). IL-1-pretreated rats also had increased lung catalase and glucose-6-phosphate dehydrogenase (G6PDH) activity and increased plasma catalase activity compared with sham-pretreated rats. In contrast to reducing lung leak, IL-1 pretreatment did not reduce the numbers of neutrophils that are increased in lung lavages of rats given IL-1 intratracheally.

Post-insult treatment with interleukin-1 receptor antagonist decreases oxidative lung injury in rats given intratracheal interleukin-1.

Systemic administration of recombinant human interleukin-1 receptor antagonist (IL-1Ra) caused a rapid and sustained elevation of plasma IL-1Ra levels and decreased the leak of intravascularly injected 125I-labeled albumin into lungs of rats given human recombinant interleukin-1 intratracheally. IL-1Ra treatment decreased leak when given 0.5 h before, 1.

Interleukin-1-induced lung neutrophil accumulation and oxygen metabolite-mediated lung leak in rats.

We found that intratracheal administration of recombinant interleukin-1 alpha (IL-1) into rats rapidly (< 5 h) increased neutrophils in lung lavages and caused an acute edematous lung injury which was reflected by lung albumin accumulation (lung leak) and histological abnormalities (perivascular cuffing). These IL-1-dependent processes were inhibited by prior administration of recombinant IL-1 receptor antagonist and did not occur following administration of heated IL-1. Several lines of evidence suggested that neutrophil-derived oxygen metabolites contributed to lung leak.

Liposome-entrapped PGE1 posttreatment decreases IL-1 alpha-induced neutrophil accumulation and lung leak in rats.

We found that treatment with liposome-entrapped prostaglandin E1 (Lip-PGE1), but not with empty liposomes and/or free PGE1, decreased the leak of intravascularly administered 125I-labeled albumin into lungs of rats given interleukin-1 alpha (IL-1 alpha) intratracheally. Lip-PGE1 treatment also decreased lung myeloperoxidase activity, lung lavage neutrophil increases, and lung histological abnormalities found in rats given IL-1 alpha intratracheally. Interestingly, decreased lung leak and lung neutrophil accumulation occurred when Lip-PGE1 was given intravenously 2.

Bullosis diabeticorum. A report of two cases with a review of the literature.

Bullosis diabeticorum is a rare complication of long-standing diabetes mellitus. Bullous lesions, which appear like burn-induced blisters, occur suddenly without trauma in the feet. These bullae heal spontaneously without scarring; however, recurrence is common.