Perforane

There are three major types of diabetic foot infections deep abscesses, cellulitis of the dorsum, and mal perforans ulcers of the sole of the foot. Osteomyelitis may occur in 30% to 40% of infections. 

Sterflinger K, de Baer R, de Hoog GS, de Wachter R, Krumbein WE, Haase G Coniosporium perforans and C. appollinis, two new rock inhabiting fungi isolated from marble in the Sanctuary of Delos (Cyclades, Greece). Antonie Van Leeuwenhoek 1997 72 349-363. 

Patients may not be compliant with drug therapy due to side effects, the need for follow-up visits, and a lack of perceived need. Thorough patient education is critical. The 5-year mortality rate associated with scleromalacia perforans is as high as 73% therefore appropriate and timely referral and comanagement with the appropriate medical specialist is important in minimizing mortality. 

Lesion color and examination lighting can play a crucial role in scleritis evaluation. For example, red-free light can be used to enhance blood vessels and may allow the clinician to observe areas of vascular closure (Figure 28-6) within a scleritis lesion. These areas represent vascular occlusion and destruction from progressive infiltrative inflammation. Except in scleromalacia perforans, anterior scleritis creates a characteristic bluish red or purplish (violaceous) color in contrast to the salmon red or bright red injection observed in episcleritis. This violaceous... 

Elastosis perforans serpiginosa Pseudoxanthoma elasticum Cutis laxa (hyperelastica)... 

Elastosis perforans serpiginosa, cutis laxa, and pseudoxanthoma elasticum... 

Elastosis perforans serpiginosa starts as red umbUicated papules that coalesce to form annular (serpiginous or arcuate) lesions with clear centres. There are microscopically thickened coarse elastic fibers, extruding through narrow epidermal channels. 

In one patient the characteristic features of both of elastosis perforans serpiginosa and cutis laxa developed (276). 

Bardach H, Gebhart W, Niebauer G. Lumpy-bumpy elastic fibers in the skin and lungs of a patient with a peniciUamme-induced elastosis perforans serpiginosa. J Cutan Pathol 1979 6(4) 243-52. 

Layton AM, Cunliffe WJ. Electrocautery as a successful treatment for penicillamine-induced elastosis perforans serpiginosa. J Dermatol Treat 1991 2 111-12. 

Sahn EE, Maize JC, Garen PD, Mullins SC, Silver RM. D-penicillamine-induced elastosis perforans serpiginosa in a child with juvenile rheumatoid arthritis. Report of a case and review of the literature. J Am Acad Dermatol 1989 20(5 Pt 2) 979-88. 

Price RG, Prentice RS. Penicillamine-induced elastosis perforans serpiginosa. Tip of the iceberg Am J Dermatopathol 1986 8(4) 314-20. 

Matsushita A, Hiruma M, Ogawa H, Watanabe S, Saeki T. A case of D-penicillamine-induced elastosis perforans serpiginosa in a women with systemic sclerosis. Nishinihon J Dermatol 1999 61 451. ... 

Hill VA, Seymour CA, Mortimer PS. Pencillamine-induced elastosis perforans serpiginosa and cutis laxa in Wilson s disease. Br J Dermatol 2000 142(3) 560-1. 

Freshwater mollusc shells and carbonate pebbles are frequently perforated by the cyanophytes Hyella fontana Huber et Jadin and Schizothrix perforans (Ercegovic) Geitler. Schizothrix lacustris A. Braun is a facultative borer that participates both in lacustrine carbonate crust deposition and excavation of furrows in carbonate rocks in lakes (Schneider, 1977). 

Yung CW+,JAm Acad Dermatol 6, 31 7 (passim) Elastosis perforans serpiginosa... 

Three major types of foot infections are seen in diabetic patients deep abscesses, cellulitis of the dorsum, and mal perforans ulcers. Most deep abscesses involve the central plantar space (arch) and are caused by minor penetrating trauma or by an extension of infection of a nail or web space of the toes. Skin infections of the dorsal area generally arise from infections in the toes that are related to routine care of the nails, nailbeds, and calluses of the toes. Mal perforans ulcer is a chronic ulcer of the sole of the foot. The ulcer develops on thickened, hardened calluses over the first or fifth metatarsal. Mal perforans ulcers are associated with neuropathy, which is responsible for the misalignment of the weight-bearing bones of the foot. Osteomyelitis is one of the most serious complications of foot problems in diabetic patients and may occur in 30% to 40% of infections. ... 

Carbon skeletons ofkylinane, perforane, cydoperfoiane, and Jnedo-perfbane... 

---