Epidermolytic hyperkeratosis in a Hispanic family resulting from a mutation in the keratin 1 gene.

Epidermolytic hyperkeratosis (EHK; bullous congenital ichthyosiform erythroderma) is a genodermatosis resulting from mutations in either the keratin 1 (K1) or keratin 10 (K10) genes. It is characterized by erythroderma and blistering at birth, and the development of ichthyotic hyperkeratosis and palmoplantar keratoderma. A wide variety of mutations within the highly conserved helix initiation and termination motifs of the central rod domains of the K1 or K10 genes correlate with the highly variable phenotypic severity observed in EHK.

Invasive Trichophyton rubrum resembling blastomycosis infection in the immunocompromised host.

A 55-year-old renal transplant recipient with onychomycosis and chronic tinea pedis presented with tender nodules on his left medial heel. He then developed papules and nodules on his right foot and calf. A skin biopsy demonstrated periodic acid-Schiff (PAS) positive, thick walled round cells, 2 to 6 microm in diameter, in the dermis.