Dermatomycoses are defined as the fungal infections of the skin including hair and nail. Generally, dermatomycoses are divided into superficial mycoses involving hair, nail and horny layer of the epidermis, and deep mycoses involving dermis and subcutis. Superficial mycoses described herein are dermatophytosis, candidiasis and Malassezia infection. Histopathologic findings of onychomycosis were a little more focused because of recently increased interest of its usefulness in making the diagnosis of onychomycosis and its causative fungi. Deep mycoses of the skin include primary or secondary dermal and/or subcutaneous fungal infections. Deep mycoses reported only in Korea were briefly described herein. Those are sporotrichosis, the most common primary cutaneous deep mycosis in Korea, and rare deep mycoses including chromoblastomycosis, phaeohyphomycosis, mycetoma, cutaneous paecillomycosis, aspergillosis, cryptococcosis, mucormycosis, systemic candidiasis, fusariomysosis, and trichophytic granuloma. Cutaneous protothecosis, a disease by achlorophilic algae, was also included because of its similarity of clinical and pathological findings with deep mycoses.
Aspergillosis ; Candidiasis ; Chromoblastomycosis ; Cryptococcosis ; Dermatomycoses* ; Dermis ; Diagnosis ; Epidermis ; Fungi ; Granuloma ; Hair ; Korea ; Malassezia ; Mucormycosis ; Mycetoma ; Mycoses ; Onychomycosis ; Phaeohyphomycosis ; Skin ; Sporotrichosis ; Tinea

The authors surveyed the present situation for imported (introduced) mycoses from papers published in Japan by the end of December, 2001. The results revealed 31 cases of coccidioidomycosis, 33 of histoplasmosis, 17 of paracoccidioidomycosis and one of penicilliosis marneffei. In coccidioidomycosis the ages ranged from 12 to 55, for 27 males and 4 females of which 2 were fatal. For histoplasmosis, the ages ranged from 17 to 74 of which 24 cases were male and 8 female. All of the patients with paracoccidioidomycosis were infected in Latin American countries. They consisted of 15 males and 2 females, and the ages ranged from 24 to 68. A single case of penicilliosis marneffei (38 years old, male) was reported very recently. The case was complicated by AIDS and became critical. Blastomycosis has not yet been reported. This survey indicates that the number of the imported mycoses in Japan is increasing. It is necessary for the persons concerned to counter measures to cope with this situation.
Blastomycosis ; Coccidioidomycosis ; Female ; Histoplasmosis ; Humans ; Japan* ; Male ; Mycoses* ; Paracoccidioidomycosis

The authors surveyed the present situation for imported (introduced) mycoses from papers published in Japan by the end of December, 2001. The results revealed 31 cases of coccidioidomycosis, 33 of histoplasmosis, 17 of paracoccidioidomycosis and one of penicilliosis marneffei. In coccidioidomycosis the ages ranged from 12 to 55, for 27 males and 4 females of which 2 were fatal. For histoplasmosis, the ages ranged from 17 to 74 of which 24 cases were male and 8 female. All of the patients with paracoccidioidomycosis were infected in Latin American countries. They consisted of 15 males and 2 females, and the ages ranged from 24 to 68. A single case of penicilliosis marneffei (38 years old, male) was reported very recently. The case was complicated by AIDS and became critical. Blastomycosis has not yet been reported. This survey indicates that the number of the imported mycoses in Japan is increasing. It is necessary for the persons concerned to counter measures to cope with this situation.
Blastomycosis ; Coccidioidomycosis ; Female ; Histoplasmosis ; Humans ; Japan* ; Male ; Mycoses* ; Paracoccidioidomycosis

Fungal diseases are grouped arbitarily into three broad categories based on the predominant location of infection within the body : superficial, cutaneous and subcutansous, and systemic. The Histopathologic features of more common fungal diseases were summarized in the table 1. and described in the text briefly. Herein described were superficial mycoses including dermatophytoses, pityriasis versicolor, cutaneous and subcutaneous including chromomycosis, rhinosporiodiosis, sporotrichosis, and systemic mycoses such as aspergillosis, candidiasis, cryptococcosis, fusariosis, zygomycosis and pneumocystosis. Characteristic and main histologic findings are granulomatous inflammation with respective organisms. The diagnosis of mycotic disease has four basic approach: clinical, mycologic, immunologivc and pathologic. Variety of host reaction are noted from non-specific reaction to granulomatous or mycetoma formation. Most important thing is mycological isolation and identification in the tissue. Multiple sections and special stains such as Gomori`s methenamine silver, Perioidic Acid Schiff, mucin stains, gram stains, acid fast stain, Giemsa stains are also very useful.
Aspergillosis ; Azure Stains ; Candidiasis ; Chromoblastomycosis ; Coloring Agents ; Cryptococcosis ; Diagnosis ; Fusariosis ; Inflammation ; Methenamine ; Mucins ; Mycetoma ; Mycoses ; Pneumonia, Pneumocystis ; Sporotrichosis ; Tinea ; Tinea Versicolor ; Zygomycosis

Indonesia is a tropical country and is the largest archipelago in the world. The country consists of more than 17,000 islands, although only 6,000 are inhabited by a population of more than 201 million people. In tropical countries, superficial mycosis are prevalent all the time, pytiriasis versicolor, several clinical forms of tineas and cutaneous candidosis comprise the most common spectrum of the disease. In our clinic this group diseases ranks the second or third place after dermatitis and acne vulgaris. Besides these common superficial fungal diseases, tines imbricate is endemic in eastern parts of islands in Indonesia. Sporotrichosis, chromomycosis, mycetoma and subcutaneous zygomycosis are occasionally seen in our clinic. The incidence of mycosis profunda is 0~2 per year in our department. Besides dermatomycosis, systemic mycosis s. a. lung aspergillosis, candidosis of the G. I. tract were also observed. Other systemic mycosis reported as endemic are histoplasmosis and cryptococcosis.
Acne Vulgaris ; Chromoblastomycosis ; Cryptococcosis ; Dermatitis ; Dermatomycoses ; Histoplasmosis ; Incidence ; Indonesia ; Islands ; Mycetoma ; Pulmonary Aspergillosis ; Skin* ; Sporotrichosis ; Tinea ; Zygomycosis

BACKGROUNDInvasive fungal infections are an important cause of posttransplant mortality in solid-organ recipients. The current trend is that the incidence of invasive candidiasis decreases significantly and invasive aspergillosis occurs later in the liver posttransplant recipients. The understanding of epidemiology and its evolving trends in the particular locality is beneficial to prophylactic and empiric treatment for transplant recipients.

METHODSA retrospective analysis was made of recorded data on the epidemiology, risk factors, and mortality of invasive fungal infections in 352 liver transplant recipients.

RESULTSForty-two (11.9%) patients suffered from invasive fungal infection. Candida species infections (53.3%) were the most common, followed by Aspergillus species (40.0%). There were 21 patients with a superficial fungal infection. The median time to onset of first invasive fungal infection was 13 days, first invasive Candida infection 9 days, and first invasive Aspergillus infection 21 days. Fifteen deaths were related to invasive fungal infection, 10 to Aspergillus infection, and 5 to Candida infection. Invasive Candida species infections were associated with encephalopathy (P = 0.009) and postoperative bacterial infection (P = 0.0003) as demonstrated by multivariate analysis. Three independent risk factors of invasive Aspergillus infection were posttransplant laparotomy (P = 0.004), renal dysfunction (P = 0.005) and hemodialysis (P = 0.001).

CONCLUSIONSThe leading etiologic species of invasive fungal infections are Candida and Aspergillus, which frequently occur in the first posttransplant month. Encephalopathy and postoperative bacterial infection predispose to invasive Candida infection. Posttransplant laparotomy and poor perioperative clinical status contribute to invasive Aspergillus infection. More studies are needed to determine the effect of prophylactic antifungal therapy in high risk patients.

Adult ; Aspergillosis ; etiology ; Candidiasis ; etiology ; Cryptococcosis ; etiology ; Female ; Humans ; Liver Transplantation ; adverse effects ; Lung Diseases, Fungal ; etiology ; Male ; Middle Aged ; Mycoses ; etiology ; Retrospective Studies ; Risk Factors

We report a case of eumycetoma in a Filipino patient who presented with a solitary reddish brown, moist, multinodular tumor on the dorsum of the left foot of 2 years duration. Biopsy with Periodic acid Schiff (PAS) & Gomori methenamine silver (GMS) staining, fungal culture, ultrasound and X-ray of the foot were done in our institution which confirmed the diagnosis of eumycetoma. The patient was successfully treated with itraconazole 400/day for 3 months, followed by 200mg/day for the succeeding 9 months, leading to complete resolution of the lesion leaving an atrophic hypopigmented scar. A high index of suspicion supported by diagnostic tests aided in the early detection of the disease which also resulted to complete resolution of the disease.
Mycetoma ; Mycoses ; Itraconazole

The diagnoses of superficial mycoses such as dermatophytosis, cutaneous candidiasis and Malassezia infections are relatively easy, and direct smear with KOH and culture with Sabouraud's dextrose agar media are the most useful and valuable methods. Recently, the incidence of onychomycosis has been increasing and some other diagnostic methods, especially for onychomycosis, and their significance has been introduced and investigated. This review was focused especially on the findings and significance of histopathologic and KONCPA methods (KOH Treated Nail Clippings Stained with PAS) for the diagnosis of onychomycosis. Summaries and brief comments were also made for the findings and significance of other diagnostic methods as well as for the differential diagnoses of superficial mycoses.
Agar ; Candidiasis, Cutaneous ; Diagnosis* ; Diagnosis, Differential* ; Glucose ; Incidence ; Malassezia ; Mycoses* ; Onychomycosis ; Tinea

BACKGROUND: The complication rate of fungal disease is higher among patients with hematological malignancies. We investigated the clinicobacteriological outcomes of resected pulmonary fungal infections complicating hematological malignancies. METHODS: Between 2001 and 2017, 21 patients with pulmonary fungal infections complicating hematological malignancies underwent resection, and their clinical records and survival were retrospectively reviewed. RESULTS: The median age of the patients was 47 years, and 13 were male. The histological diagnoses were pulmonary aspergillosis (19 cases), mucormycosis (1 case), and cryptococcosis (1 case). The indications for surgery were resistance to antifungal therapy and the necessity of surgery before hematopoietic stem cell transplantation in 13 and 8 cases, respectively. The diagnoses of the hematological malignancies were acute myelogenous leukemia (10 cases), acute lymphocytic leukemia (5 cases), myelodysplastic syndrome (3 cases), and chronic myelogenous leukemia, malignant lymphoma, and extramedullary plasmacytoma (1 case each). The surgical procedures were partial resection (11 cases), segmentectomy (5 cases), lobectomy (4 cases), and cavernostomy (1 case). The size of the lesions was 0.9–8.5 cm. Fourteen cases had cavitation. There were no surgical-related deaths or fungal progression. CONCLUSION: Pulmonary fungal infections are resistant to treatments for hematological malignancies. Since the treatment of the underlying disease is extended and these infections often recur and are exacerbated, surgery should be considered when possible.
Cryptococcosis ; Diagnosis ; Hematologic Neoplasms* ; Hematopoietic Stem Cell Transplantation ; Humans ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive ; Leukemia, Myeloid, Acute ; Lung Diseases, Fungal* ; Lymphoma ; Male ; Mastectomy, Segmental ; Mucormycosis ; Mycoses ; Myelodysplastic Syndromes ; Plasmacytoma ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; Pulmonary Aspergillosis ; Retrospective Studies ; Thoracic Surgery

The awareness of classification and differential diagnosis of deep mycoses, particularly systemic infections due to pathogenic fungal infections, is essential for the early detection on and appropriate therapy. These systemic pathogenic fungal infections such as histoplasmosis, African histoplasmosis, paracoccidioidomycosis, blastomycosis, are usually endemic in limited areas of continents of America, and Africa. A newly recognized penicilliosis due to Penicillium marneffei, a dimorphic fungus, used to be endemic in Southeast Asia, is now world-wide new threat because the increased numbers of cases have been reported in Australia, France, Italy, the Netherlands, United Kingdom, and the United States. Because of the increased international visitors to the endemic areas and a significant enlargement of the populations existing in immunocompromized state, thus susceptible to systemic mycoses, we, the primary care physicians should be on the alert for the clinicopathologic aspects of the systemic mycoses to make a diagnosis early enough to institute effective therapy.
Africa ; Americas ; Asia, Southeastern ; Australia ; Blastomycosis ; Classification ; Diagnosis ; Diagnosis, Differential* ; France ; Fungi ; Great Britain ; Histoplasmosis ; Humans ; Italy ; Mycoses* ; Netherlands ; Paracoccidioidomycosis ; Penicillium ; Physicians, Primary Care ; United States