Solitary asymptomatic nodule of the great toe.

Subungual exostosis is a benign osteocartilaginous tumor of the ungual apparatus, particularly of the toes. It affects both sexes equally, more frequently in the second and third decades of life. We describe a 6-year-old girl who came to our attention because of the enlargement of a pinkish nodule in the distal part of the nail bed of the first toe, progressively elevating the nail plate.

Strongyloidiasis histologically mimicking eosinophilic folliculitis.

The authors report an unusual case of strongyloidiasis in an Italian patient, who has always lived in Sicily. The patient presented with marked blood eosinophilia and an itching maculo-papular eruption, histologically simulating eosinophilic folliculitis. The clinical resolution was achieved after albendazol therapy.

Cutaneous angiosarcoma of the face.

Cutaneous angiosarcoma is a rare tumour of vascular origin, which has a poor prognosis because of its high potential for metastasis. We report the case of a 57-year-old man with an 8-month history of a progressively enlarging, asymptomatic red patch over the left periorbital region of the face, previously diagnosed as angiolupoid leishmaniasis, insect-bites, 'cellulitis' and treated with several topical antibiotic and steroid therapy, without any improvement. A skin biopsy of the lesion was performed and histological and immunohistochemical examination revealed a pattern of poorly differentiated angiosarcoma.

Erythematous-edematous-infiltrative plaque on the face: cutaneous angio-lupoid leishmaniasis.

The present report deals with an unusual clinical presentation of cutaneous leishmaniasis occurring in an atopic subject and discusses the possible pathogenetic mechanisms with particular attention to the role of nitric oxide in the immunological control against intracellular parasites. The altered balance between TH1 and TH2, typical of atopy, with consequent production of IL-4, might contribute to the high susceptibility to opportunistic infections and to the unusual clinical presentation. Moreover the laxity of the tissue and the great vascularization may enhance cutaneous expression of the Leishmania infestation, producing new aspects which add to the difficulty of diagnosis.