Mucocutaneous infection with Candida spp. in infants ranges from such common conditions as thrush and diaper dermatitis to serious diseases with potential for systemic involvement. High-risk infants with mucosal or skin involvement with Candida spp. much more likely develop into systemic candidiasis. Consideration should be given to obtaining systemic cultures, skin biopsy and treating with systemic antifungal therapy in many such cases. We report a case of mucocutaneous candidiasis in a baby with extremely very low birth weight, who was treated with oral fluconazole.
Biopsy ; Candida ; Candidiasis* ; Candidiasis, Oral ; Dermatitis ; Fluconazole ; Humans ; Infant ; Infant, Very Low Birth Weight* ; Skin

Kerion celsi is a highly inflammatory, supprative fungal infection of the scalp caused mainly by zoophilic dermatophytes transmitted from animals to man. We report a case of kerion celsi caused by Trichophyton (T.) mentagrophytes in 9 year-old male, who showed 10 x 9 cm and 2 x 1 cm sized, markedly inflammatory, boggy masses on the scalp and erythematous scaly patch on the philtrum. Cultures from a scalp lesion of the patient on Sabouraud glucose agar showed T. mentagrophytes. Treatment was done systemically with steroid and antifungal agents.
Agar ; Animals ; Antifungal Agents ; Arthrodermataceae ; Child ; Glucose ; Humans ; Lip ; Male ; Scalp ; Tinea Capitis* ; Trichophyton*

BACKGROUND: Seborrheic dermatitis is a very common chronic inflammatory disease. The causal factor of the disease is still unknown, but early investigators focused on the role of Malassezia yeasts. These yeasts are also normal skin commensals, thus their importance as pathogens in this disorder came to be doubted. However, it was subsequently found that treatment of seborrheic dermatitis with an antifungal agent not only resulted in clinical improvement but also reduced the number of Malassezia yeasts on the skin. OBJECT: The purpose of this study is to confirm relationship between seborrheric dermatits and Malassezia yeast, and to evaluate the therapeutic efficacy of oral itraconazole in the seborrheic dermatitis. METHODS: Using the scrub-wash technique in the glabella and swabbing technique in the scalp, the number of cultured Malassezia yeasts were counted in 30 patients with seborrheic dermatitis and 20 control persons. The patients took itraconazole, 100mg/day, during 4weeks. The clinical and mycologic score were measured at the initial evaluation, followed after 2weeks and 4weeks RESULT: The number of Malassezia yeasts in patient with seborrheic dermatits were significantly higher than in normal control group. There was statistically significant decrease in the clinical and mycological score after a 4 week trial of oral itraconazole in the seborrheic dermatitis group. CONCLUSION: This study indicates that Malassezia yeast may be one of the important causative factor of seborrheic dermatitis and itraconazole plays an important role in the treatment of seborrheic dermatitis
Dermatitis, Seborrheic* ; Humans ; Itraconazole* ; Malassezia ; Research Personnel ; Scalp ; Skin ; Yeasts

BACKGROUND: Tinea faciale is a dermatophyte infection of glabrous skin of the face except bearded areas of the adult male. Tinea faciale usually has been classified as tinea corporis but recently recognized as a separate disease entity. OBJECTIVE: The purpose of this study is to evaluate the correlation of clinical and mycological features of tinea faciale. METHODS: We performed clinical and mycological study on 46 cases of tinea faciale at the department of dermatology, Konkuk University Hospital from September 2001 to August 2004. RESULTS & CONCLUSIONS: 1. The age distribution of patients was highest in the age group of 10 years or under (34.8%). The ratio of male to female patient was 1: 1.4. The seasonal distribution of patients was highest in autumn. 2. Among 46 cases, dermatophytes were isolated in 37 cases. They were Trichophyton (T.) rubrum (19 cases), Microsporum (M.) canis (9 cases), T. mentagrophytes (6 cases), M. gypseum (2 cases), and Epidermophyton (E.) floccosum (1 case). 3. Although there was no notable discrepancies among the age groups, in both T. rubrum and T. mentagrophytes. M. canis was found to be more frequent as the main causative organism in the age group of 10 years or under. According to seasonal variation, there were no significant differences among T. rubrum species. M. canis was seen more frequently during winter season, and T. mentagrophytes in spring. 4. There were no significant difference in clinical variations of tinea faciale according to the type of dermatophytes. Coexisting fungal infections were found in 10 patients and tinia corporis was most frequently.
Adult ; Age Distribution ; Arthrodermataceae ; Dermatology ; Epidermophyton ; Female ; Humans ; Male ; Microsporum ; Seasons ; Skin ; Tinea* ; Trichophyton

BACKGROUND: In Korea, Trichophyton (T.) rubrum is occupied more than 80% of causative fungi of dermatophytosis. Strain differentiation of T. rubrum is essential for epidermiologic study. OBJECTIVE: The aim of this study is to develope the primers for amplification of rDNA intergenic spacer (IGS) to detect polymorphism of T. rubrum. METHODS: The primers were designed from 25S and 18S of rDNA, and were applied to 20 strains of T. rubrum, which included 1 standard strain and 19 clinical isolates. RESULTS: Primers for amplification of polymorphic rDNA IGS were designed from the 3'end of the 25S (primer ANID25-3, 5'-GACAGGTTAGTTTTACCCTACTGA-3') and the 5'end of the 18S (TR18-2R, 5'- ATCTAATAAATACACCCCTTCCGA-3'). PCR condition was adjusted for detecting polymorphism. Best results were obtained at 55degrees C for annealing temperature and 3 minutes for extension time. Eight bands sized as 1.1, 2.4, 2.7, 2.9, 3.2, 3.8, 5 kb were amplified with PCR using the primers. With 4 bands sized 2.7, 2.9, 3.2 and 3.8 kb, 20 strains of T. rubrum could be grouped into 6 subtypes. CONCLUSION: The PCR fingerprinting with the primers for rDNA IGS was able to differentiated strains of T. rubrum, and it can be applied in clinical and epidemiologic studies. The primer could be applied to other fungi with unknown sequences.
Dermatoglyphics ; DNA, Ribosomal* ; Fungi ; Korea ; Polymerase Chain Reaction ; Tinea ; Trichophyton*

BACKGROUND: Trichophyton (T.) tonsurans infection has been increasing gradually in non-athletes, i.e. general population as well as athletes since it was first reported that athletes had been infected in Korea in 1995, whereas it is a common dermatophyte species in the United States and Europe. OBJECTIVE: We performed retrospective study to observe tinea infections caused by T. tonsurans. METHOD: The clinical and epidermiological study was made with 105 patients of T. tonsurans infection among out-patients in our skin clinic from March, 1995 to December, 2003. RESULT: In 105 cases of T. tonsurans infection 73 ones were athletes such as wrestlers and judo players, and 32 ones were non-athletes. The infected skin lesions of 114 cases showed mild to moderate inflammation, whereas 7 ones showed moderate to severe inflammation. The results of KOH wet mount were positive in 92 cases (87.6%). In fungal culture with Potato dextrose agar-corn meal-tween 80, the mahogany variety (53.3%) was more than the sulfreum one (22.8%), which was less significant because the percentage of unclassified cases (23.8%) influenced on variety distribution considerably (p> 0.05, chi-test). Microscopic findings of cultured fungus showed hyphae with match-box type microconidia. Preferred anatomical sites were scalp (35.2%), face (32.4%), upper extremities (16.2%), and neck (14.3%). The rate of sex was 89 cases in male and 16 ones in female. The mean age was 16.1+/-4.6, ranged from 3 to 44 years. There is no difference between athletes and non-athletes. Preferred seasons were winter (44.8%) and spring (33.3%). The occurrence of the cases in athletes, which reached the peak in 1997, has been maintained since 1995, while the number of the cases in non-athletes has minimally increased until 2003. Throughout this study it proves that the occurrence of the infection has been disseminating with athletes of a hand-to-hand fight through a lot of physical contact in the center because of frequent athletic meetings since T. tonsurans was introduced in Korea in 1995. Moreover, there is a increasing tendency toward T. tonsurans infection in non-athletes. Therefore, athletic and medical associations should make continual observations of T. tonsurans infection and take close consideration into systematic management and strategy against the infection in order to suppress probable prevalence of the contagion in our society.
Arthrodermataceae ; Athletes ; Europe ; Female ; Fungi ; Glucose ; Humans ; Hyphae ; Inflammation ; Korea ; Male ; Martial Arts ; Neck ; Outpatients ; Prevalence ; Retrospective Studies ; Scalp ; Seasons ; Skin ; Solanum tuberosum ; Sports ; Tinea ; Trichophyton* ; United States ; Upper Extremity

Majocchi's granuloma is well recognized, uncommon infection of dermal and subcutaneous tissue by dermatophytes. The organism usually associated with Majocchi's granuloma is Trichophyton (T.) rubrum. However, other dermatophytes including T. mentagrophytes, T. violaceum, M. audouinii, M. gypseum, M. ferrugineum, and M. canis may be the causative agent. Dermatophytes usually do not invade beyond epidermis. However mechanical breakage of the skin resulting from scratching or trauma and immunocompromised state, such as diabetes mellitus, malignancy, and long term steroid use may allow penetration of fungi together with keratin and necrotic materials into the dermis. A 19-year-old woman presented with erythematous patch on the left lower extremity for 2 years. She had a history of breeding pet dog infected with fungus 3 years ago and treated with antifungal agent for 6 months in local clinic under the impression of tinea corporis. The examination revealed erythematous discrete papulopustular patch with brownish to violaceous scaly margin. KOH examination showed negative result, but histopathologic finding of pustular skin lesion showed chronic granulomatous inflammation with fungal element. The fungal culture grew T. mentagrophytes. The patient was started on itraconazole 200mg daily for 4 weeks and successfully treated. Herein we report a case considering of Majocchi's granuloma by T. mentagrophytes.
Animals ; Arthrodermataceae ; Breeding ; Dermis ; Diabetes Mellitus ; Dogs ; Epidermis ; Female ; Fungi ; Granuloma* ; Humans ; Inflammation ; Itraconazole ; Lower Extremity ; Skin ; Subcutaneous Tissue ; Tinea ; Trichophyton* ; Young Adult

Systemic candidiasis is a fatal fungal infection and its diagnosis is often difficult because Candida organism may be cultured from blood specimens in only 25% of the patients. The triad of systemic candidiasis is fever, papular rash, and diffuse muscle tenderness. Therefore, the recognition of the characteristic cutaneous lesions of disseminated candidiasis allows earlier diagnosis and treatment. The cutaneous lesion usually consists of red or purpuric papules, some with pale centers, abscess, necrotic lesion, hemorrhage and skin lesion mimicking ecthyma gangrenosum. We report a rare case of disseminated candidiasis presented as multiple subcutaneous nodule-typed skin lesions.
Abscess ; Candida ; Candidiasis* ; Diagnosis ; Ecthyma ; Exanthema ; Fever ; Hemorrhage ; Humans ; Myalgia ; Skin

BACKGROUND: Onychomycosis is one of the most common diseases of nails, accounting for 50% of all nail problems and a recent rise in the prevalence of onychomycosis has been noted. It has been known that the growth rate of nails is influenced by age, sex, seasonal factor, individual health and familial tendency. Several drugs, also, have been known to influence the growth rate of nails. OBJECTIVE: We want to know the influence of antifungal drug, itraconazole and terbinafine that used widespread recently, to the growth rate of nail. METHODS: This study was performed the 41 patients with distal subungal onychomycosis affecting only one sided great toenail and affected area more than 50%. The growth rate of the affected and the unaffected toenails in the same patients according to the medication of itraconazole or terbinafine was measured. Also, the growth rate of nails in 36 people with normal toenail was measured. RESULTS: No growth rate differences were seen in comparing the great toenails affected to onychomycosis in itraconazole and terbinafine group (p> 0.05). Also no growth rate differences were seen in great toenails not affected to onychomycosis in itraconazole and terbinafine group and no growth rate differences with the toenails of normal control (p> 0.05). CONCLUSION: There was no difference of itraconazole or terbinafine to the growth rate of nail. Even though there was no statistical significance, the possibility of the drug effect as normal nail growth became faster with the antifungal medication can not be excluded. So study with comparison of nail growth rate before and after antifungal medication will be needed in the future.
Humans ; Itraconazole ; Nails* ; Onychomycosis* ; Prevalence ; Seasons

BACKGROUND: Although in managing childhood onychomycosis, it is reported that continuous therapy of itraconazole is effective and safe, pulse therapy seems to be preferred to enhance patient's compliance and tolerability. Still, there is a relatively limited data regarding clinical characteristics and efficacy of itraconazole pulse therapy in childhood onychomycosis. OBJECTIVE: The purpose of this study was to evaluate the clinical characteristics of childhood onychomycosis and efficacy of itraconazole pulse therapy in childhood onychomycosis. METHODS: The study has been processed from 1999 August to 2003 April regarding total 28 patients, age under 14 years old. Clinical evaluation was performed on the bases of age, sex, site, clinical type, risk factors and existence of other concomitant fungal infections. Diagnosis was confirmed by KOH mount and fungal culture. Fungal slide culture was performed to identify the causative organism. Itraconazole was administered 5mg/weight (kg) 2 pulses for finger nail infection and 3 pulses for toe nail infection. Then the follow up was done as scheduled, and we evaluated clinical improvement and adverse effect regularly at every visit. RESULTS: Twenty five patients (male 16, female 9; mean age 8.7 years) completed the follow-ups. 6 patients (24%) had lesions on the finger nail and 19 patients (76%) on the toe nail. Studied clinical type were distolateral subungual onychomycosis (DLSO) and whitish superficial onychomycosis (WSO), but predominantly DLSO; 3 patients on the finger nail and 18 on the toe nail, 21 (84%) totally presenting the most commonly involved. Tinea unguium and tinea pedis-related family history was found in 18 patients (72%). Other concomitant fungal infections were found in 21 patients (84%). As causative organism, only Trichophyton (T.) rubrum was identified in 17 patients (68%). Clinical cure rate was 84%, while treatment failure was 16%. CONCLUSION: Childhood onychomycosis showed similar clinical chracteristics with adulthood and itraconazole pulse therapy was effective for childhood onychomycosis.
Adolescent ; Compliance ; Diagnosis ; Female ; Fingers ; Follow-Up Studies ; Humans ; Itraconazole* ; Onychomycosis* ; Risk Factors ; Tinea ; Toes ; Treatment Failure ; Trichophyton