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Malakoplakia of the skin. Ultrastructure and quantitative x-ray microanalysis of Michaelis-Gutmann bodies
Abstract:
The etiologic agent in a case of malakoplakia of the skin was identified as Staphylococcus aureus from culture of the lesion and from ultrastructural observations. Ultrastructurally, electron-dense inclusions were observed in addition to membranous whorls and Michaelis-Gutmann (MG) bodies. These were labeled "precalcification formations" since they possessed an organic crystalline structure. These formations may act as nucleation centers for further incorporation of organic and inorganic material. Deposition of fine crystalline material in the outer region may occur as the structure becomes saturated with inorganic elements, thus completing formation of the MG body. Quantitative x-ray microanalysis of MG bodies demonstrated the presence of phosphorus, calcium, and iron, with average concentrations of 2.1%, 2.6%, and 0.7% by weight, respectively.
Insights
Staphylococcus aureus is identified as the cause of skin malakoplakia. Ultrastructural analysis revealed precalcification formations that contribute to Michaelis-Gutmann body development in this condition.
Area of Science:
- Dermatology
- Microbiology
- Pathology
Background:
- Malakoplakia is a rare inflammatory condition of unknown etiology.
- Identifying the causative agent and understanding the pathogenesis of malakoplakia is crucial for effective treatment.
Observation:
- The etiologic agent in a case of skin malakoplakia was identified as Staphylococcus aureus through lesion culture and ultrastructural analysis.
- Ultrastructural examination revealed electron-dense inclusions, membranous whorls, and Michaelis-Gutmann (MG) bodies.
- Unique 'precalcification formations' with organic crystalline structure were observed, potentially acting as nucleation centers for MG body formation.
Findings:
- Precalcification formations may initiate the accretion of organic and inorganic materials.
- Saturation with inorganic elements leads to the deposition of crystalline material, completing MG body formation.
- Quantitative x-ray microanalysis of MG bodies showed significant concentrations of phosphorus (2.1%), calcium (2.6%), and iron (0.7%).
Implications:
- This study elucidates the role of Staphylococcus aureus in skin malakoplakia.
- Understanding the formation of Michaelis-Gutmann bodies provides insights into the pathogenesis of malakoplakia.
- The identification of precalcification formations offers a novel perspective on the mineralization process in this condition.