PMC4782659_01
Punched-out lesions on the plantar surface of the left halux (B); larger
erosions in the metatarsal region (A and C)
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On examination, small punched-out lesions were noted on the plantar surface of the left halux and larger erosions were seen in the metatarsal region of both feet (Figure 1).
Scanning electron microscopy - A. decreased horny layer (x 100) with
absence of the regular elimination of corneocytes B. normal plantar skin
with corneocytes (x 100). C. hypokeratosis in the acrosyringium (x
1,200) D. normal skin with the presence of corneocytes arranged in a
circular manner in the acrosyringium (x 450)
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Analysis at small magnification revealed a decreased horny layer with absence of the regular elimination of corneocytes, as seen in the normal plantar skin (Figure 2). Examination of the acrosyringium also showed hypokeratosis, differently of the presence of corneocytes arranged in a circular manner in the acrosyringium of the normal skin (Figure 2).
Scanning electron microscopy - coccoid bacteria found on the plantar
surface (x 3.500) with detail of the transversal septation (inset x
10,000)
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At higher magnification (x 3,500), bacteria were easily found on the surface and the described transversal septation was observed (Figure 3).
Scanning electron microscopy- tunnel openings with bacteria in the
stratum corneum (x 4,500)
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In addition, the tunnels opened by the bacteria in the stratum corneum could be better seen in other areas (Figure 4).