Microsporum (M.) canis is one of the zoophilic dermatophytes which can cause ringworm in cats and dogs and is responsible for 3~30% of tinea corporis and tinea capitis in human. It is most likely transmitted by contact with infected animals, but rare cases of person-to-person transmission and an outbreak among school girls have also been reported. Herein we report on interesting cases of tinea corporis caused by M. canis in a grandmother and a granddaughter. A 63-year-old woman presented with pruritic, scaly, erythematous plaques on the post. neck and trunk which had started 2 months ago. Also her 9-year-old granddaughter presented with pruritic, annular, erythematous plaques on chest and back for 7 days. They denied contact with animals. KOH smear showed several hyphaes on microscope. Fungus culture on potato dextrose agar showed growth of colonies with whitish fluffy surface and radial folds, the dorsal surface of the colonies showed golden-brown color which were identified as M. canis in both patients. As for the grandmother the lesions improved with oral itraconazole 200 mg/day for 7 days and topical antifungal cream for 5 weeks which resulted in marked improvement of the lesions.
Agar ; Animals ; Arthrodermataceae ; Cats ; Child ; Dogs ; Female ; Fungi ; Glucose ; Humans ; Hyphae ; Itraconazole ; Microsporum* ; Middle Aged ; Neck ; Solanum tuberosum ; Thorax ; Tinea Capitis ; Tinea*

BACKGROUND: The macrophages activated by lipopolisaccharide produce numerous molecules and proteins, such as tumor necrotic factor-alpha (TNF-alpha), interleukin-6 (IL-6), IL-1beta, inducible nitric oxide synthase (iNOS), cyclooxygenase-2 (COX-2), and free radicals, associated with inflammation. The response was occurred by intracellular cascaded, NF-kappaB pathway. So, the regulation of this pathway is very important in control of inflammation. OBJECTIVE: In this study, the anti-inflammatory and anti-oxidant effects of Sophora flavescens that is used empirically in oriental medicine and folk remedy were evaluated and the mechanism of the effects was studied. METHODS: By using the root extracts of Sophora flavescens, we performed experiment in LPS and interferon-gamma (IFN-gamma)-activated Raw 264.7 cells. We measured the production of NO, PGE2 and expression of iNOS and COX-2 in activated Raw 264.7 cells with Sophora flavescens root extract. Also, we tested anti-oxidant effect of Sophora flavescens root extracts by ELISA kit in activated Raw 264.7 cells, and the free radical scavenging effect of material itself by DPPH assay. RESULTS: The Sophora flavescens root extracts decreased the production of NO (p<0.001) and PGE2 (p<0.01) in Raw 264.7 cells activated by LPS and IFN-gamma. The expression of proteins, iNOS and COX-2, suppressed along with the elevated concentration of Sophora flavescens root extracts. The result of DPPH assay was that the test material itself had scavenging effect for free radical (p<0.001). And the antioxidant activity in activated Raw 264.7 cells was increased with the level of the Sophora flavescens root extracts (p<0.05). CONCLUSION: The Sophora flavescens root extracts suppressed the production of NO and PGE2 through the decreased expression of iNOS and COX-2. And the Sophora flavescens root extracts had the scavenging effect about free radicals itself and increased the antioxidant activity in activated macrophages.
Antioxidants ; Cyclooxygenase 2 ; Dinoprostone ; Enzyme-Linked Immunosorbent Assay ; Free Radicals ; Inflammation ; Interferon-gamma ; Interleukin-6 ; Macrophages ; Medicine, East Asian Traditional ; Medicine, Traditional ; NF-kappa B ; Nitric Oxide Synthase Type II ; Proteins ; Sophora

No abstract available.
Pulmonary Aspergillosis ; Tomography, X-Ray Computed ; Foreign Bodies

Mucormycosis occurs primarily in patients with severe underlying illness, especially leukemia, lymphoma, and uncontrolled diabetes mellitus. Cutaneous mucormycosis is somewhat less frequently associated with systemic illness than other forms of mucormycosis. The associated mortality is significantly less than that related to rhinocerebral form. More recent reports have shown that primary cutaneous mucormycosis has emerged as an important form of the disease. It develops where a break in the integrity of the skin has occurred as a result of surgery, bum, or other forms of trauma. We report a case of primary cutaneous mucormycosis in a healthy person without systemic illness, which was successfully treated with amphotericin B therapy for 2 weeks.
Amphotericin B ; Diabetes Mellitus ; Humans ; Leukemia ; Lymphoma ; Mortality ; Mucormycosis* ; Skin

We presented here a case of the primary cutaneous cryptococcosis in a patient with iatrogenic Cushing's syndrome. The patient was 72-year-old female and showed painful shallow ulcer with pus discharge on the left forearm. She had been receiving systemic corticosteroids without doctor's prescription for 20 years. Laboratory findings revealed impaired cell mediated immunity, decreased serum and urine cortisol, and ACTH. A biopsy specimen showed granulomatous reaction consisting of lymphohistiocytes, multinucleated giant cell, and many spores with thick capsules. A tissue and pus culture of the lesion on Sabouraud's media at 37 degrees C showed moist smooth, mucoid creamy colored colonies 3 days later and revealed encapsulated yeast cells in the India ink preparations. The patient was successfully treated with oral itaconazole and fluconazole without side effects.
Adrenal Cortex Hormones ; Adrenocorticotropic Hormone ; Aged ; Biopsy ; Capsules ; Cryptococcosis* ; Cushing Syndrome* ; Female ; Fluconazole ; Forearm ; Giant Cells ; Humans ; Hydrocortisone ; Immunity, Cellular ; India ; Ink ; Prescriptions ; Spores ; Suppuration ; Ulcer ; Yeasts

Crytococcus neofomans is an encapsulated budding yeast with well-defined ecological biotopes and the second most common nose of the fungal infection in immunocompromised patients. It is 18re for a cryptoccosis infection to be localized only to the skin. We report two cases of cryptococcosis mimicking cellulitis. The frist case was suspected as primary cutaneous cyptococcosis in the 57-year-old female SIE patient who had been treated with prednisolone 60 mg/day for 1 month. Erythematous swollen patch developed on the left thigh and subsided spontaneously without relation to the course of 519 after 2 weeks of onset. The second case developed in the 45-year-old female patient with adrenal cancer. Erythematous patches developed on the medial sides of both thighs. The lesions were resistant to the combination therapy of amphotericin B 0-7 mg/kg/day and 5-fluorocytosine 100 mg/kg/day and the patient died after 1 month of treatment.
Adrenal Gland Neoplasms ; Amphotericin B ; Cellulitis* ; Cryptococcosis ; Female ; Flucytosine ; Humans ; Immunocompromised Host ; Middle Aged ; Nose ; Prednisolone ; Saccharomycetales ; Skin ; Thigh

Paecilomyces lilacinus is an ubiquitous saprophytic fungus and very rarely pathogenic to the human. Although it has been reported to cause endophthalmitis, orbital cellulitis, prosthetic valve endocarditis, and pulmonary infection, cutaneous infection caused by Paecilomyces lilacinus has been rarely reported. A 46-year-old Korean man had asymptomatic slowly growing multiple cutaneous nodules on the left arm and wrist for 8 months. He received a renal transplantation in 1991 because of end-stage renal disease. Postoperatively, he has taken cyclosporin and deflazacort for immunosuppression. Physical examination revealed that the lesions were discrete or confluent, firm, elevated, well-defined fluctuating nodules. Histologic section showed multiple well-encapsulated intradermal abscesses with some foci of chronic granulomatous changes composed of lymphocytes, histiocytes and giant cells. PAS positive fungal hyphae and spores were also found. On the Sabouraud's dextrose agar media, the organism grew rapidly to form velvety lilac-colored colonies with shallow radiating furrows. Slide culture showed brush-like conidiophores ending in flask-shaped phialides carrying chain of conidia. Because of the poor response to the oral antifungal drug for 2 months, all the lesions were completely excised.
Abscess* ; Agar ; Arm ; Cyclosporine ; Endocarditis ; Endophthalmitis ; Fungi ; Giant Cells ; Glucose ; Histiocytes ; Humans ; Hyphae ; Immunosuppression ; Kidney Failure, Chronic ; Kidney Transplantation ; Lymphocytes ; Middle Aged ; Orbital Cellulitis ; Paecilomyces* ; Physical Examination ; Spores ; Spores, Fungal ; Wrist

We report three cases of kerion celsi caused by Trichophyton tonsurans in 16-year-old students of one high school wrestling team. The first case presented a 10x5cm and several 3~4cm sized, markedly inflammatory, boggy lesions on the scalp for 5 months. Other cases showed several 2~4cm sized, erythematous, follicular pustules and nodules with partial alopecia on the scalp for 2 months. Histopathology and results of mycologic study were consistent with kerion celsi due to Trichophyton tonsurans. All lesions were successfully treated with griseofulvin 500mg daily for 7~15weeks and short term therapy of low dose of prednisolone and cephadroxil.
Adolescent ; Alopecia ; Griseofulvin ; Humans ; Prednisolone ; Scalp ; Tinea Capitis* ; Trichophyton* ; Wrestling

BACKGROUND: The effectiveness of some therapeutic modalities for cutaneous sporotrichosis may be changed depending on the individual and geographic characteristics, and the clinical type. Itraconazole has been known to be effective for it, however, there have been no standard and ideal guideline on the oral dosage and duration yet. OBJECTIVE & METHODS: In this study, we evaluated the effectiveness of oral itraconazole in patients with cutaneous sporotrichosis in relation to dosage and clinical status. The observation of 17 patients with sporotrichosis were made retrospectively Oral itraconazole was administered at the dose of 200 mg daily in 15 adults over 18 years old and 100 mg in the other 2 children. RESULTS: The duration for healing was within 30 days in 4 cases, within 60 days in 4 cases, within 90 days in 2 cases, within 120 days in 3 cases, and within 150 days of therapy in 2 cases. The average duration in all cases was 12.1+/-8.6 weeks. Comparison our results to the previous reported one revealed that more shorter treatment time was needed in cases treated with 200 mg daily than that with 100 mg. There was no treatment failure by drug intolerance or resistance. The duration for healing was significantly shorter in the patient groups with prevalence duration more than 5 months, however there was not any significant difference in sex of patients, and the clinical types. The cases with the lesion on the face and cases with fixed type tended to be healed more rapidly than the others. CONCLUSION: Oral itraconazole may be a safe and e(fictive antifungal agent for the treatment of cutaneous sporotrichosis in a daily dose of 200 mg for 3 months on the average. However, duration for healing could be influenced by the clinical status.
Adolescent ; Adult ; Child ; Humans ; Itraconazole* ; Prevalence ; Retrospective Studies ; Sporotrichosis* ; Treatment Failure

BACKGROUND: Toenail onychomycosis still remains difficult to treat. Pulse therapy of itraconazole is frequently prescribed to lighten the patient's burden of economical problems, frequent side effects, resulting in good compliance. OBJECTIVE: The purpose of this study is to evaluate the clinical efficacy and adverse reactions of pulse therapy of itraconazole. METHODS: From March to September 1996, a total of 108 patients with onychomycosis of toenail diagnosed at Department of Dermatology of 5 university hospitals, were enrolled in a subject group for the study. Itraconazole was administered, 200 mg twice daily, in every first week of 3 consecutive months. Clinical symptoms and sings with or without mycologic findings were assessed at baseline, at the end of 4, 8, 12, 24, 36 and 48 weeks after the start of therapy. RESULTS: Fifty six patients (male 22, female 34; mean age 44.0+/-13.3) completed the follow-ups. As causative agents, Trichophyton(T.) rubrum was isolated in 51 of them, T. mentagrophytes 2, and yeast 3. Decrease in initial percentages of patients showing pathologic changes in target nail at the last follow-up 12 months after starting therapy : for onycholysis, from 51.8% to 21.4%; for subungual hyperkeratosis, from 96.4% to 39.3%; for nail discoloration, from 100.0% to 50.0%. Mycological cure rate was 82.1% at the last follow-up. Overall clinical responses evaluated at the last follow-up were cured in 28 patients (50.0%), 'markedly improved' in 15 (26.8%), 'moderately improved' in 9 (16.1%), and 'deteriorated' in 4 (7.1%), making a clinical response rate of 92.9%. During therapy, transient epigastric pain and indigestion developed in 2 patients (3.6%), respectively. CONCLUSION: With these results, itraconazole pulse therapy is considered an effective and safe treatment modality for onychomycosis of toenail.
Compliance ; Dermatology ; Dyspepsia ; Female ; Follow-Up Studies ; Hospitals, University ; Humans ; Itraconazole* ; Nails* ; Onycholysis ; Onychomycosis* ; Yeasts