In the genealogical investigation into 1210 patients with alopecia areata(AA), we found 75 cases with a positive family history of AA, the familial incidence was 6.2%. The incidence of AA in the 75 families (1093 cases) was 14.91% (163 cases). In these families, there were 142 patients in first-grade relatives of the family members, 17 in second-grade, and 4 in third-grade. We observed 70 cases in 33 families within one generation, 87 cases in 40 families within two succesive generations, and 6 cases in 2 families within three successive generations, four pairs of monozygotic twins appeared in this investigation, but just one of each pair was affected. The relationship between pathogenesis of AA and genetic factor has been discussed.

Objective To report two cases of Candida parapsilosis-caused candidiasis characterized by verrucous nodules and masses,and to assess their clinical features,diagnosis and treatment.Methods A medical history including medication history and therapeutic response was carefully collected from two male patients.Physical examination was carried out with a focus on skin lesions.Diagnosis was made according to medical history as well as physical,mycological and histopathological examination findings.Antifungal agents were given at a high enough dose in time.After lesions improved,the doses of antifungal agents were tapered gradually,and drugs were withdrawn until patients completely healed.Compound preparations containing both antifungal agents and glucocorticoids were also topically applied in the early period of treatment.Results Both patients were diagnosed as Candida parapsilosis-caused candidiasis characterized by verrucous nodules and masses,and cured after 100-day supporting treatment and antifungal treatment with oral itraconazole,etc.Conclusions Candida parapsilosis-caused candidiasis should be managed with combination therapy mainly including antifungal agents.To achieve a satisfying efficacy,antifungal agents should be given early at a high enough dose for a long enough period.

16 ?g/mL, and ≤0.03 ?g/mL , respectively. The MICs did not show significant differences among the ungerminated conidia and the germinated conidia for all the isolates tested except A.versicolor and Phialophora verrucosa. Conclusions Terbinafine is effective against the isolates of Aspergillus spp., dematiaceous fungi and dermatophytes in vitro except Pseudallescheria boydii and Scedosporium apiospermum. The MIC of terbinafine obtained with ungerminated conidia may reflect the antifungal activity of terbinafine against germinated conidia and hyphae of some filamentous fungi in vitro.

Objective To investigate the DNA polymorphism of Pseudallescheria boydii and Scedosporium apiospermum and to analyze the relationship between random amplification of polymorphic DNA (RAPD) patterns and geographic origins.Methods The genomic DNAs of 13 Pseudallescheria boydii strains and 18 Scedosporium apiospermum strains isolated from 5 countries were amplified with RAPD technique.Results All strains tested were classified into 31 patterns by combination of the results obtained with 3 primers.The cluster tendency was identified based on species difference,namely,P.boydii or S.apiospermum strains,however,no such cluster tendency was revealed based on geographic origins of the most of strains,by dendrogram analysis.Conclusions The infraspecific variability of P.boydii and S.apiospermum is considerable.The cluster tendency of RAPD profiles is of consistency with morphological properties of P.boydii and S.apiospermum to some degree,however,is of no correlation with geographic origins of the pathogenic strains.

Objective To study the expression and the role of interferon-gamma (IFN-?)in murine systemic infection of Scedosporum apiospermum. Methods The murine models of systemic Scedosporum apiospermum infection was established by inoculation of the pathogenic fungi. ELISA and RT-PCR were applied to detect the expression level of IFN-? protein and mRNA in spleens, respectively. Colony formingunit (cfu) of infected kidneys was determined with the plating dilution method. The mean survival time (MST) of the mice was also recorded. Results IFN-? levels in lethal infection group were lower than those of the normal controls (P 0.05 on day 7). IFN-? levels of sublethal infection group were higher than those of normal controls (P 0.05 on day 7). But the IFN-? levels were significantly lower in the immunosuppressed group than those in the sublethal infection group (P

To re-identify and further group 25 isolates of Trichosporon spp. identified morphologically previously, sequences of D1/D2 region of large subunit (LSU) of ribosomal DNA (rDNA) of 25 tested strains for identification and those of ribosomal intergenic space 1 (IGS1) region of 11 strains for subgrouping were detected. The identifications of tested strains were changed except 6 strains. According to the alignment of the IGS1 region, 6 T. asahii isolates tested fell into 4 groups and 5 T. faecale isolates into 3 groups. Polymorphism of 2 T. japonicum isolates was found in 10 positions. With the alignments obtained in this research compared with the relative GenBank entries, it was found that T. asahii, T. faecale and T. japonicum species were divided into 7, 3 and 2 subtypes respectively. Morphological and biophysical methods are not sufficient for Trichosporon spp. identification. Sequencing becomes necessary for Trichosporon diagnosis. There is obvious diversity within a species.

Objective To analyze fungal isolates from patients with superficial fungal infections during 1960-2006.Methods Fungal strains isolated from patients with superficial (mucocutaneous and cutaneous)fungal infections and identified in the Medical Mycology Clinical Laboratory,Department of Dermatology and Venereology,Union Hospital,from 1960 to 2006 (data from September 1991 to July 1992 were unavailable),were subjected to a classification and statistical analysis.Clinical samples for mycological examination were taken from outpatients or inpatients of different departments in hospitals of Hubei province and surrounding areas.Morphological,physiological and biochemical methods were applied for species identification.Results A total of 11 989 Candida strains were isolated,which belonged to 23 species and 16 genera.They fell into 3 groups,i.e.,dermatophytes,Candida and yeasts (including Malassezia),and non-dermatophyte moulds.Since 287 strains of moulds were suspected to be contaminating fungi,11 702 residual isolates were analyzed.Of the analyzed isolates,Candida species (5642/11 702,48.2％ )and dermatophytes (5279/11 702,45.1％ )predominated,followed by yeasts (449/11 702,3.8％) and Malassezia species (332/11 702,2.8％).The most frequently isolated species was Trichophyton rubrum (3865/11 702,33.0％),Candida albicans (3110/11 702,26.6％ ) and non-albicans Candida species (2532/11 702,21.6％ ).Dermatophyte strains were mostly isolated from lesions of smooth skin with an exception of palmoplantar and interdigit regions (1787/5279,37.7％).The most common dermatophyte species was Trichophyton rubrum,followed by Trichophyton violanceum.Candida was mainly isolated from mucous membrane lesions (4099/5642,72.7％),with Candida albicans being the predominant species.Conclusions Candida species and dermatophytes predominate in patients with superficial fungal infections during 1960-2006,with Trichophyton rubrum being the most common species.

To re-identify and further group 25 isolates of Trichosporon spp. identified morphologically previously, sequences of D1/D2 region of large subunit (LSU) of ribosomal DNA (rDNA) of 25 tested strains for identification and those of ribosomal intergenic space 1 (IGS1) region of 11 strains for sub-grouping were detected. The identifications of tested strains were changed except 6 strains. According to the alignment of the IGS1 region, 6 T. asahii isolates tested fell into 4 groups and 5 T. faecale isolates into 3 groups. Polymorphism of 2 T.japonicum isolates was found in 10 positions. With the alignments obtained in this research compared with the relative GenBank entries, it was found that T. asahii, T.faecale and T.japonicum species were divided into 7, 3 and 2 subtypes respectively. Morphological and biophysical methods are not sufficient for Trichosporon spp. identification. Sequencing becomes neces-sary for Trichosporon diagnosis. There is obvious diversity within a species.

Objective: To evaluate the accuracy of automated fluorescence microscopic imaging and computer-aided diagnosis system (AFMICADS) in the auxiliary diagnosis of superficial cutaneous fungal infections. Methods: Totally, 106 outpatients and inpatients with suspected superficial fungal infections were enrolled from clinical departments of Union Hospital, Tongji Medical College, Huazhong University of Science and Technology between July 2018 and September 2018. A total of 126 specimens were collected, including 83 skin scales and 43 nail parings. Each specimen was divided into 3 groups to be examined by conventional fungal microscopy, culture with modified Sabouraud dextrose agar and fluorescence microscopy (artificial fluorescence microscopy and AFMICADS-based fluorescence microscopy) respectively. A positive result was defined as that conventional fungal microscopy and/or fungal culture was positive. Consistency rate, sensitivity and specificity of the 3 microscopic methods were calculated. Statistical analysis was carried out with SPSS 10.0 software by using McNemar test and Kappa test for analyzing difference in the positive rate, as well as consistency, between the 3 microscopic methods and the positive standard, and by using efficiency test for comparing the consistency rate among the 3 microscopic methods. Results: Of 126 specimens, 124 (98.4%) were positive for artificial fluorescence microscopy, and 123 (97.6%) for AFMICADS-based fluorescence microscopy. Both positive rates of the above 2 microscopic methods were significantly higher than the positive rate of the positive standard (77.8%, both P < 0.001) . The sensitivity, specificity and consistency rate of AFMICADS-based fluorescence microscopy were 100%, 10.7% and 80.2% respectively, and those of artificial fluorescence microscopy were 100%, 7.1% and 79.4% respectively. Additionally, no significant difference in the consistency was observed between the AFMICADS-based and artificial fluorescence microscopy (P > 0.05) . Conclusion The accuracy of AFMICADS-based fluorescence microscopy in the diagnosis of superficial cutaneous fungal infections is similar to that of artificial fluorescence microscopy.