RESUMEN

BACKGROUNDS: Basal cell carcinoma (BCC) is the most common cutaneous neoplasm. Despite numerous previous studies, the origin of BCC is still controversial. OBJECTIVE: The aim of this study is to evaluate whether BCC arises from the hair follicle rather than the epidermal basal cell. METHODS: The labeling index and differences of expression of the immunohistochemical (IHC) stainings of CK15, CK19, follistatin, and Bmi-1 were evaluated in 20 cases of BCC, 13 cases of trichoblastoma, 21 cases of actinic keratosis (AK), and 19 cases of squamous cell carcinoma (SCC) which were biopsied in the department of dermatology of the Yeungnam University Medical Center. RESULTS: For CK15, labeling indexes of BCC (83.0%) and trichoblastoma (84.4%) were significantly higher than those of AK (15.9%) and SCC (15.8%). For CK19, labeling indexes of BCC (8.1%), trichoblastoma (6.6%), AK (3.5%), and SCC (14.8%) revealed no difference. For follistatin, labeling indexes of BCC (51.1%) and trichoblastoma (70.1%) were significantly higher than those of AK (0.9%) and SCC (8.5%). For Bmi-1, labeling indexes of BCC (74.4%) and trichoblastoma (84.7%) were significantly higher than those of AK (24.7%) and SCC (18.6%). CONCLUSION: In this study, strong positivity of CK15, follistatin, and Bmi-1 was more frequently observed in BCC and trichoblastoma than in SCC and AK. These findings suggest that BCC and trichoblastoma share the same differentiation toward the hair follicle. Furthermore, CK15, follistatin, and Bmi-1 can be useful as markers to differentiate BCC from SCC.

Asunto(s)

Carcinoma Basocelular/patología , Carcinoma de Células Escamosas/patología , Folistatina/metabolismo , Queratina-15/metabolismo , Queratina-19/metabolismo , Neoplasias Cutáneas/patología , Biomarcadores de Tumor/metabolismo , Biopsia con Aguja , Carcinoma Basocelular/metabolismo , Carcinoma de Células Escamosas/metabolismo , Estudios de Casos y Controles , Femenino , Humanos , Inmunohistoquímica , Queratosis Actínica/metabolismo , Queratosis Actínica/patología , Masculino , Proteína Quinasa 7 Activada por Mitógenos/metabolismo , Estudios Retrospectivos , Sensibilidad y Especificidad , Neoplasias Cutáneas/metabolismo , Estadísticas no Paramétricas

RESUMEN

Onychomycosis is usually caused by dermatophytes, but some species of nondermatophytic molds and yeasts are also associated with nail invasion. Aspergillus niger is a nondermatophytic mold which exists as an opportunistic filamentous fungus in all environments. Here, we report a case of onychomycosis caused by A. niger in a 66-year-old female. The patient presented with a black discoloration and a milky white base and onycholysis on the proximal portion of the right thumb nail. Direct microscopic examination of scrapings after potassium hydroxide (KOH) preparation revealed dichotomous septate hyphae. Repeated cultures on Sabouraud's dextrose agar (SDA) without cycloheximide produced the same black velvety colonies. No colony growth occurred on SDA with cycloheximide slants. Biseriate phialides covering the entire vesicle with radiate conidial heads were observed on the slide culture. The DNA sequence of the internal transcribed spacer region of the clinical sample was a 100% match to that of A. niger strain ATCC 16888 (GenBank accession number AY373852). A. niger was confirmed by KOH mount, colony identification, light microscopic morphology, and DNA sequence analysis. The patient was treated orally with 250 mg terbinafine daily and topical amorolfine 5% nail lacquer for 3 months. As a result, the patient was completely cured clinically and mycologically.