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Malassezia Species Cultured from the Lesions of Malassezia Folliculitis.

Soo Jung JANG ; Yong Beam CHOI ; Kyu Joong AHN

Korean Journal of Medical Mycology.2003;8(2):55-62.

BACKGROUND: The yeasts of genus Malassezia are dimorphic and lipophilic and are numbers of the normal flora in humans. Malassezia yeasts are implicated in various diseases, including pityriasis versicolor, Malassezia folliculitis, seborrheic dermatitis and systemic fungal infections. OBJECT: The study was done to classify the Malassezia yeasts cultured from the lesions of Malassezia folliculitis into one of the revised species and to find out the relationship between certain species of Malassezia and Malassezia folliculitis. METHODs: The specimen obtained from the lesions of twenty cases of Malassezia folliculitis and twenty cases of healthy controls were cultured on Leeming & Notman's media. The obtained strains were placed into one of the seven species by their colony morphologies, microscopic morphologies and physiological characteristics. RESULTS: In the lesions of Malassezia folliculitis, M. globosa occupied most of the cultured colonies in 15 cases, M. restricta in 4 cases and M. furfur in 1 case respectively. In the control group, M. restricta was found to be predominant on the face and M. sympodialis, M. globosa, M. restricta and M. furfur were isolated on the trunk. CONCLUSION: M. restricta and M. globosa could be considered to be mostly implicated species in the seven revised Malassezia species in the lesions of Malassezia folliculitis of the face and trunk respectively.
Dermatitis, Seborrheic ; Folliculitis* ; Humans ; Malassezia* ; Tinea Versicolor ; Yeasts

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Growth Rate of the Great Toenails in the Diabetic and Non-diabetic with or without Onychomycosis.

Hyeok Man KWON ; Jeong Soo KIM ; Hee Joon YU

Korean Journal of Medical Mycology.2003;8(2):48-54.

BACKGROUND: The diabetic patients have a tendency to develop onychomycosis more frequently than non-diabetic populations have. The overall risk ratio of individuals with diabetes having onychomycosis is 2.77 compared with age- and sex- matched non-diabetic controls. OBJECTIVE: This study was performed to find out whether the nail growth rates of diabetic patients are more slower than those of non-diabetic persons with or without onychomycosis and to observe the differences of the toenail growth rates according to the affected area of onychomycosis (less than 50% and more than 50%) within the diabetic and non-diabetic groups respectively. METHOD: The growth rates of the great toenails of 74 diabetic patients and 121 non-diabetic controls with or without onychomycosis were measured. To compare the toenail growth rates between the two groups, we classified the patients in each group into 3 subgroups according to the presence and degree of onychomycosis. Thus the two groups were divided into 6 groups. RESULTS: The growth rates of diabetic toenails without onychomycosis were slower than those of non-diabetic controls with statistical significance (p< 0.05). And the growth rates of the great toenails in non-diabetic patients were more slower according to their affected area, so to say, the more, the slower (p< 0.05). But, in diabetic patients, the growth rates of the great toenails were not different according to the affected area of onychomycosis (p> 0.05). CONCLUSION: Slow nail growth may play a role in the development of onychomycosis because the nail growth rate was slower in diabetic patients than non-diabetics. But the treatment of onychomycosis in diabetic patients should be encouraged because the toenail growth rates are not different statistically between diabetic and non-diabetic patients when the great toenails are affected.
Diabetes Mellitus ; Humans ; Nails* ; Odds Ratio ; Onychomycosis*

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Are Psoriatic Nails Predisposed to Fungal Infection?.

Joanna SALOMON ; Jacek C SZEPIETOWSKI ; Alina PRONIEWICZ

Korean Journal of Medical Mycology.2003;8(2):43-47.

BACKGROUND: Onychomycosis is a very common and widespread disorder, however the incidence of onychomycosis in psoriatic patients is not accurately assessed. OBJECTIVE: : The present study was undertaken to evaluate the frequency of fungal infections of the nails changed in the course of psoriasis and to provide an answer whether psoriatic nails are specially predisposed to fungal infections. MATERIAL AND METHODS: 83 psoriatic patients with nail changes participated in the study. Among them there were 25 females and 58 males, aged 18~76 years. 59 patients (71.1%) had psoriasis vulgaris, the remaining ones - 24 subjects (28.9%) suffered from arthropathic psoriasis. In any case of nail abnormalities clinically suspected of fungal infection the further mycological investigations were performed. Fungal infections were finally diagnosed on the base of direct microscopy and positive culture. The Chi2 test and the Mann-Whitney U-test were used for statistical analysis. RESULTS: Positive mycological cultures were obtained from 15 patients (18%). The most commonly isolated fungi were moulds cultured in 6 patients (37%), followed by dermatophytes - 5 patients (31.5%) and yeast-like fungi - also 5 subjects (31.4%). Moulds and yeast-like fungi were found in both fingernails and toenails; all dermatophyte infections were diagnosed on the toenails. Psoriatic patients with fungal nail infections were older than those with negative mycological examination and the duration of psoriasis in this group of patients was also longer. Although the above differences between two studied groups were evident, they did not reach the statistical significance. CONCLUSIONS: Based on the achieved results it is difficult to assess definitely whether psoriasis is a predisposing factor to the development of fungal infections of the nails.
Arthrodermataceae ; Causality ; Female ; Fungi ; Humans ; Incidence ; Male ; Microscopy ; Nails ; Nails, Malformed ; Onychomycosis ; Psoriasis

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Current and Emerging Antifungal Agents in Japan.

Hideyo YAMAGUCHI

Korean Journal of Medical Mycology.2003;8(2):35-42.

Currently available antifungal agents for the treatment of systemic fungal infections in Japan are smaller in number than those in the United States and Europe and probably in Korea. Therefore, the development of novel antifungal drugs for clinical use, including new formulations of approved agents, with advantages over and/or complimentary to existing agents is particularly needed in Japan. In this review, I have described historical perspectives of existing systemic antifungal agents and provided a brief overview of the current status of clinical development of several different categories of new drugs as follows: (1) liposomal amphotericin B; (2) itraconazole-hydroxypropyl-beta-cyclodextrin complexes; (3) phosphatyl fluconazole (phosfluconazole) ; (4) voriconazole; and (5) micafungin (FK463). At this moment, micafungin, a member of echinocandins attracts the greatest attention of Japanese medical mycologists because it has just been introduced into the clinic and has unique chemical and biological characteristics distinct from any other existing class of antifungal drugs. Micafungin, as well as other new drugs under clinical development, should constitute effective new options for the management of a variety of systemic fungal infections.
Amphotericin B ; Antifungal Agents* ; Asian Continental Ancestry Group ; Echinocandins ; Europe ; Fluconazole ; Humans ; Japan* ; Korea ; Population Characteristics ; United States

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A Case of Cutaneous Prototheocsis.

Jin Hee JUN ; Jee Bum LEE ; Seong Jin KIM ; Seung Chul LEE ; Young Ho WON

Korean Journal of Medical Mycology.2003;8(1):30-34.

Protothecosis is an infection caused by achloric algae of the genus Prototheca. It is found ubiquitously in nature, particularly in the slime flux of trees and sewage. Only two species including Prototheca wickerhamii and Prototheca zopfii have been known to be pathogenic in humans. A 64-year-old man presented intermittent pruritic erythematous confluent grouped papules and nodules on the left upper arm. Histopathologic study revealed some sporangia of morula-like appearance and chronic granulomatous inflammation. The PAS stain demonstrated the characteristic spores showing multiple internal septations and some unicellular endospore. P. wickerhamii was isolated from culture and identified by the biochemical studies. Oral itraconazole 200 mg/day administration resulted in marked regression of the skin lesion after 8 weeks.
Arm ; Humans ; Inflammation ; Itraconazole ; Middle Aged ; Prototheca ; Sewage ; Skin ; Sporangia ; Spores

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A Case of Chromoblastomycosis Treated with Terbinafine.

Chan Woo LEE ; Seung Joo SIM ; Ki Hoon SONG ; Ki Ho KIM

Korean Journal of Medical Mycology.2003;8(1):26-29.

Chromoblastomycosis is a chronic fungal infection of the skin and subcutaneous tissues caused by pigmented or dematiaceous fungi that are implanted into the dermis from the external environment. The vast majority of infections are caused by Fonsecaea pedrosoi and Cladosporium carrionii. Several drugs, such as itraconazole, amphotericin B, terbinafine, have been tried with variable success and various therapeutic techniques, including radiotherapy, cryosurgery, electrodesiccation and surgical excision, can be applied as a further treatment. So far, there are five cases filed as chromoblastomycosis in Korea. Four of them are reported from the southern part of the Korea. Intralesional injection or occlusive dressing of Amphotericin B, and oral administration of intraconazole have been used for the treatment in reported cases. Now, we report firstly a case of chromoblastomycosis treated with terbinafine. A 54-year-old Korean teacher had 10 x 5.5 cm sized dark purple colored plaque with crusts 4 years earlier as a linear plaque after an injury by the thorns of wooden chair. A skin biopsy revealed pseudoepitheliomatous hyperplasia and dermal infiltration of mixed inflammatory cells and Touton type multinucleated giant cells with numerous sclerotic cells. Several clusters of sclerotic bodies were observed also within the giant cells. On the fungus culture, the colony showed slowly growing dark-brown colored heaped appearance in 4 weeks. Isolated fungus was identified as Fonsecaea pedrosoi. Because of partial response to 10 months' itraconazole treatment, the treatment regimen was changed to terbinafine 500 mg/d with marked improvement after 4 months.
Administration, Oral ; Amphotericin B ; Biopsy ; Chromoblastomycosis* ; Cladosporium ; Cryosurgery ; Dermis ; Fungi ; Giant Cells ; Humans ; Hyperplasia ; Injections, Intralesional ; Itraconazole ; Korea ; Middle Aged ; Occlusive Dressings ; Radiotherapy ; Skin ; Subcutaneous Tissue

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A Case of Onychomycosis Caused by Fusarium solani.

Sung Wook LIM ; Soon Wook KWON ; Moo Kyu SUH ; Ho Chung LEE ; Jin Hyouk CHOI ; Jeong Woo LEE ; Gyoung Yim HA

Korean Journal of Medical Mycology.2003;8(1):21-25.

Although dermatophytes are still the main etiologic agents of onychomycosis, some species of nondermatophytic molds and yeasts are also capable of invading the nails. Fusarium (F.) solani is a nondermatophytic mold which is saprophytic fungus in soil. Onychomycosis due to Fusarium species almost always involve the great toenails, particularly in the presence of traumatic or dystrophic abnormalities. We report a case of toenail onychomycosis caused by F. solani in a 42-year-old female. The patient presented with typical distal subungual onychomycosis. Direct microscopic examination of scrapings on the potassium hydroxide preparation revealed fungal elements and repeated cultures on Sabouraud's dextrose agar showed the same whitish to cream-colored, cottony colonies. Multiple, sickle-shaped, multiseptate macroconidia and long, slender monophialides were observed in the slide culture. We confirmed F. solani by gross and light microscopic morphology of the colony. The patient was treated with 250 mg of terbinafine daily for 3 months.
Adult ; Agar ; Arthrodermataceae ; Female ; Fungi ; Fusarium* ; Glucose ; Humans ; Nails ; Onychomycosis* ; Potassium ; Soil ; Yeasts

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A Case of Primary Cutaneous Cryptococcosis Misdiagnosel as Skin Tuberculosis.

Yu Jin KIM ; Seong Jun SEO ; Byung In RO

Korean Journal of Medical Mycology.2003;8(1):16-20.

Cryptococcosis is an opportunistic yeast infection caused by Cryptococcosis neoformans. The cutaneous manifestations are usually polymorphic and nonspecific. Lesions may appear as subcutaneous swelling, abscesses, tumor-like masses, papules or large ulcers. Therefore, diagnosis of cutaneous cryptococcosis is quite difficult and often delayed. Clinical suspicion is very important in diagnosis. A 47-year-old man presented with a ulcerative nodule on the right side of the neck. Because initial skin biopsy revealed granulomatous lesion, we misdiagnosed his lesion as skin tuberculosis and treated him with anti tuberculosis medication for 6 months. But his symptom was not improved. After second biopsy specimen had showed some spores with narrow neck budding, we confirmed this case as a cryptococcosis and successfully treated with itraconazole (200 mg/day) for 12 weeks.
Abscess ; Biopsy ; Cryptococcosis* ; Diagnosis ; Humans ; Itraconazole ; Middle Aged ; Neck ; Skin* ; Spores ; Tuberculosis ; Tuberculosis, Cutaneous* ; Ulcer ; Yeasts

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Genetic Diversity of Dematiaceous Fungi Using Random Amplified Polymorphic DNA.

Moo Kyu SUH ; Jin Chun SUH ; Jung Chul KIM ; Ho Chung LEE

Korean Journal of Medical Mycology.2003;8(1):7-15.

BACKGROUND: There are three kinds of diseases caused by dematiaceous fungi: chromoblastomycosis, phaeohyphomycosis, and eumycotic mycetoma. The dematiaceous fungi have been identified and classified by morphological, biochemical and physiological tests. Recently molecular analysis has been introduced to the field of medical mycology. OBJECTIVE: We investigated the genetic diversity of dematiaceous fungi using random amplified polymorphic DNA (RAPD). METHODS: The dematiaceous fungal strains studied were eight clinical isolates of chromoblastomycosis and phaeohyphomycosis agents (3 strains of Fonsecaea pedrosoi, 2 strains of Exophiala dermatitidis, 1 strain of Exophiala jeanselmei, 1 strain of Phialophora verrucosa, 1 strain of Rhinocladiella aquaspersa) and 4 standard strains (F. pedrosoi IFM 4889, E. dermatitidis IFM 4828, P. verrucosa IFM 4928, R. aquaspersa IFM 4930). Total twelve strains of dematiaceous fungi were cultured on Sabouraud's dextrose broth and their DNA were extracted by bead-beating method. RESULTS: The optimal condition for PCR was template DNA 0.025 mg and annealing temperature 39 degrees C. The RAPD analysis using OPA 10 primer (5'-GTGATCGCAG-3') of Operon kit showed different patterns among dematiaceous fungi. But one clinical isolate of F. pedrosoi showed intra-specific variability. CONCLUSION: The RAPD analysis is considered a rapid and reliable method for identification and classification of dematiaceous fungi if the procedure is carefully standardized with adequate primer.
Chromoblastomycosis ; Classification ; DNA* ; Exophiala ; Fungi* ; Genetic Variation* ; Glucose ; Mycetoma ; Mycology ; Operon ; Phaeohyphomycosis ; Phialophora ; Polymerase Chain Reaction

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The Presence of Yeast-like Fungi on Maxillary Prostheses with Obturators and in Post Surgical Cavities in Patients Operated on for Maxillary Neoplasms.

Wlodzimierz WIECKIEWICZ ; Eugeniusz BARAN ; Bogumil PLONKA ; Alina PRONIEWICZ

Korean Journal of Medical Mycology.2003;8(1):1-6.

BACKGROUND: Majority of people have yeast-like fungi on their oral mucosa. In the case of a neoplastic disease and the use of a prosthesis with obturator, the incidence of fungi increases. OBJECTIVE: To prove the presence of yeast-like fungi prior to and after lining of the prosthesis obturator and after the use of Betadina and Silosept. Swabs were taken from the post surgical cavities and the prosthesis obturators and cultured on Sabouraud agar with gentamicin and chloramphenicol (SGC) and on IDII medium manufactured by Bio Merieux, France. METHODS: The material comprised 25 patients after removal of various maxillary tumors. All the patients had prostheses with obturators. The prostheses were disinfected with 2% solution of Silosept while the mucous membrane of the post surgical cavities was covered with 0.5% Betadina gel. RESULTS: Swab cultures taken prior to the treatment revealed the growth of C. albicans in the post surgical cavity of 80% of patients and on the prosthesis obturator in 76% of cases. C. species was found on both, the prosthesis obturator and in the post surgical cavity in 64% of patients. Mycological examination of the fungi isolated from the swab after lining of the prosthesis obturator and after the application of Betadina and Silosept revealed the presence of C. albicans on the prosthesis obturator and in the post surgical cavity in 68% of patients. Candida species was revealed in the post surgical cavity in 84% of cases and on the prosthesis obturator in 88% of patients. CONCLUSION: The presence of yeast-like fungi in post surgical cavity and on the prosthesis obturator was confirmed in about 90% of cases. The fungi may be predisposed to the inflammatory conditions, which may contribute to the neoplastic metaplasia. Applied concentrations of Betadina and Silosept preparations proved ineffective in the eradication of the fungi, that is why further investigation is necessary in order to determine effective concentrations of the above agents and/or search for other effective measures.
Agar ; Candida ; Candida albicans ; Chloramphenicol ; France ; Fungi* ; Gentamicins ; Humans ; Incidence ; Maxillary Neoplasms* ; Maxillofacial Prosthesis* ; Metaplasia ; Mouth Mucosa ; Mucous Membrane ; Prostheses and Implants

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