Hyun Min Nam

Aeromonas hydrophila Sepsis Mimicking Vibrio vulnificus Infection.

Aeromonas hydrophila is a facultatively anaerobic, asporogenous gram-negative rod that has often been regarded as an opportunistic pathogen in hosts with impairment of a local or general defense mechanism. A 68-year-old alcoholic woman presented with shock and gangrene on the right arm. At first, her clinical presentations were severe painful erythematous swelling that worsened within a few hours with development of gangrene, edema, and blisters. Bullous fluid and blood cultures yielded A. hydrophila. Histopathological findings of sections obtained from the vesicle revealed subepidermal vesicles; necrosis of the epidermis, papillary dermis, and subcutaneous fat; and massive hemorrhage in the subcutis. Despite all efforts to save the patient, she died 8 hours after admission. Clinical features of A. hydrophila sepsis resemble those of Vibrio vulnificus sepsis. Therefore, in addition to the case report, we compared the cultural, biochemical, and morphological differences between A. hydrophila and V. vulnificus for facilitation of early and accurate identification of the causative agent.

Correction of Pincer Nail Deformity Using Dermal Grafting

Pincer nail deformity is characterized by excessive curvature and distortion of the nail in the transverse dimension, and particularly at the distal part of the nail plate. This deformity leads to pinching off and loss of soft tissue in the affected digit, causing severe pain. Many treatment methods have been proposed; however, an effective long-term method preserving the nail matrix has not yet been established. We present here a case of pincer nail in the left thumb in a 49-year-old woman who was treated successfully with dermal grafting under the nail bed. We describe the surgical method and the treatment results. To the best of our knowledge, this is the first report in the Korean medical literature on the use of dermal grafting for the treatment of pincer nail deformity.

Nail bed defect covered with labial mucosa graft after subungal glomus tumor removal.

The nail bed is an important part of the nail unit. It supports the nail plate, but does not regenerate itself. The labial mucosa and the nail bed both lack a granular layer. Because the keratinization of the nail bed can cause poor nail adhesion, harvesting graft from nonkeratinized sites is preferred. Furthermore, harvesting graft from labial mucosa is convenient in surgical approach. Therefore, the labial mucosa is more eligible for covering the nail bed defect than other graft methods. In this report, a 46‐year‐old female patient suffered from a subungal glomus tumor of the right fourth fingernail bed for 10 years. After the nail plate was removed, complete excision of the tumor was performed, and a labial mucosa graft was used to cover the defect. Eight months after the operation, the tumor had not reoccurred and no nail deformity was observed. This outcome demonstrates that our procedure is a good surgical option for treatment of nail bed defects.