The classification of onychomycosis, infection of the nail apparatus caused by fungi, has changed over time with the recognition of new pathways of nail infection, new organisms, and new variations in the appearance of diseased infected nail. Taking into account published descriptions of nail morphology in fungal infection, the following forms of onychomycosis are recognized: distal and lateral subungual, superficial, endonyx, proximal subungual, mixed, totally dystrophic, and secondary onychomycosis. These can be subdivided, where appropriate, by color and pattern of nail plate change. The purpose of the revised classification is to provide a framework to assist selection of treatment, estimate prognosis, and evaluate new diagnostic methods.

Onychomycosis: A proposed revision of the clinical classification

Taxane-induced nail changes: incidence, clinical presentation and outcome

UNLABELLED Docetaxel, a semisynthetic member of the taxoid class of antineoplastic agents, is effective in the treatment of patients with advanced (locally advanced or metastatic) breast cancer. Reported objective response rates for docetaxel 100 mg/m2 ranged from 54 to 69% and 53 to 82% as first-line monotherapy or combination therapy, respectively. Objective response rates of 23 to 65% and 30 to 81% have been reported for docetaxel as second-line monotherapy or combination therapy, respectively. In Japanese studies, second-line docetaxel 60 mg/m2 produced objective response rates of 42 to 55%. At the recommended dose of 100 mg/m2 given as a 1-hour intravenous (i.v.) infusion every 3 weeks, docetaxel had significantly greater efficacy than doxorubicin, mitomycin plus vinblastine and methotrexate plus fluorouracil, and similar efficacy to fluorouracil plus vinorelbine in pretreated patients with advanced breast cancer. In chemotherapy-naive patients, first-line combined therapy with docetaxel and doxorubicin had significantly greater efficacy than doxorubicin plus cyclophosphamide. Promising results have been achieved in phase I/II trials of a weekly regimen of docetaxel (generally 30 to 45 mg/m2). Preliminary data indicate a potential role for docetaxel in the neoadjuvant therapy of early breast cancer. The major dose-limiting adverse event associated with docetaxel is neutropenia. Although other adverse events are common, the tolerability profile of docetaxel is generally acceptable in the majority of patients, particularly in comparison with other antineoplastic regimens. CONCLUSIONS Although no single standard regimen has been identified as optimal for the treatment of advanced breast cancer, phase III trials have shown that docetaxel has improved efficacy over doxorubicin alone (considered one of the current gold standards), methotrexate/fluorouracil and mitomycin/vinblastine in second-line therapy. In combination with doxorubicin, docetaxel has demonstrated better efficacy than doxorubicin/cyclophosphamide in first-line therapy. These results provide a basis for therapy choice in advanced breast cancer. Clinical trials comparing docetaxel monotherapy versus paclitaxel monotherapy and versus docetaxel combination therapy are warranted. The role of docetaxel in the adjuvant and neoadjuvant treatment of early breast cancer is being evaluated.

Docetaxel: an update of its use in advanced breast cancer.

The diagnosis of enthesitis in clinical practice is difficult and usually based on conventional radiographic findings, which are not helpful in most cases.1 We previously reported that ultrasound (US) was sensitive in detecting peculiar pathological features of enthesitis around the heel.2 Furthermore, we have continued to study the efficacy of ultrasonographic diagnosis of enthesitis of other tendon and ligament insertion sites.

Sixteen patients (10 male, six female, mean age 45.6 years) with a diagnosis of seronegative arthropathy were recruited from the population for the study. Their mean disease duration was 6.3 years. They had seronegative arthropathy and knee enthesopathy without typical conventional radiographic evidence. An HDI 3000 ATL US machine (Advanced …

https://ard.bmj.com/content/annrheumdis/63/2/213.full.pdf

Ultrasound detection of knee patellar enthesitis: a comparison with magnetic resonance imaging

Objective To record 17 cases of nocardiosis in cats from eastern Australia and to compare this series with cases previously reported.



Design  Retrospective/prospective study.



Results Nocardia spp infections were diagnosed in 17 cats over 14 years from the three eastern states of Australia. There were no isolates from dogs during this period, but one isolate from a koala and two from dairy cows. The majority of cats presented with spreading lesions of the subcutis and skin associated with draining sinus tract(s). Early cutaneous lesions consisted of circumscribed abscesses. Infections spread at a variable rate, generally by extension to adjacent tissues. Lesions were generally located in regions subjected to cat bite or scratch injuries, including limbs, body wall, inguinal panniculus and nasal bridge. In some other cases, lesions were situated on distal extremities. The clinical course was variable, from chronic, indolent, initially localised infections to acute fulminating disease. Of the 17 cats, 14 were domestic crossbreds and three were purebreds. There was a preponderance of male cats (12 castrated, 1 entire young adult, 1 entire kitten). Nine of 17 cats were 10 years or older. Interestingly, the majority of infections were attributable to N nova. Immediate and/or predisposing causes could be identified in all cases, and included: renal transplantation [one cat]; chronic corticosteroid administration [three cats]; catabolic state following chylothorax surgery [one cat]; fight injuries [seven cats]; FIV infections [three of seven cats tested]. Of the 17 cats, three were apparently cured. Four were thought to be cured, but infection recurred after several months. Three cats responded partially but were euthanased, while another was improving when it died of unrelated complications. Two died despite treatment and two were euthanased without an attempt at therapy. For two cats there were either insufficient records or the patient was lost to follow up.



Conclusion  Nocardiosis is a rare, serious disease. Currently it is more common in cats than dogs. Nocardial panniculitis may be clinically indistinguishable from the syndrome caused by rapidly growing mycobacteria. Although the prognosis is guarded, patients with localised infections caused by N nova often respond to appropriate therapy. If definitive treatment is delayed because of misdiagnosis, the disease tends to become chronic, extensive and refractory. Insufficient duration of therapy leads to disease recurrence.

Nocardia infections in cats: a retrospective multi‐institutional study of 17 cases

Cat scratch responsible for primary cutaneous Nocardia asteroides in an immunocompetent patient.

Pustular vasculitis in a patient with T-cell large granular lymphocyte proliferation and myelodysplasia. Successful treatment by ciclosporin.

[Juvenile temporal arteritis: a benign disease].

Amylose vésicale localisée et sarcoïdose: analyse d'une association fortuite

Des ongles jaunes

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