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A Clinical Characteristics of Tinea Faciei and Its Mycological Findings.

Woo Jin KIM ; Dong Hoon SHIN ; Jong Soo CHOI ; Ki Hong KIM

Korean Journal of Medical Mycology.2005;10(3):91-100.

BACKGROUND: Tinea faciei (TF) is a dermatophytosis of the non-beard areas of the face. Its clinical features may be similar to that of contact dermatitis, discoid lupus erythematosus, polymorphous light eruption or seborrheic dermatitis. A differential diagnosis should be considered for these. It is important to find hyphae through potassium hydroxide (KOH) preparation. OBJECTIVE: The purpose was to evaluate clinical characteristics and mycological findings of TF. METHODS: Clinical charts of 93 patients with TF were reviewed. KOH preparation (+) and/or culture (+) from the skin lesions confirmed the diagnosis of TF. RESULT & CONCLUSIONS: Patients with TF were most prevalent under 10 years old, and relatively even in 20s to 50s. Overall male to female ratio was 1.07: 1, but differed in each age groups; male was predominant in age groups of 20s, 40s and 50s, while female in age groups of 30s and over 60. Most (74.3%) of the lesion was single and the cheek (32%) was the most frequently involved site, followed by the nose, periorbital area, chin, ear, forehead and perioral area in decreasing order. 29 patients (31.2%) had coexistent dermatophytosis in other areas of the body; tinea pedis et unguium (17.2%), tinea corporis (8.6%), tinea capitis (5.4%). 38 patients (86.4%) were treated for contact dermatitis and eczema by primary care physician before the diagnosis of TF. KOH preparation from the lesions showed positive for 95.7% of the patients. 46 strains (49.5%) were identified from the 93 patients. They were Trichophyton (T.) rubrum (65.2%), T. mentagrophytes (26.1%), Microsporum canis (6.5%) and T. verrucosum (2.2%). All of these findings suggest that localized erythematous facial lesions and if there is no response to treatment of dermatitis, examination for fungus should be considered.
Cheek ; Child ; Chin ; Dermatitis ; Dermatitis, Contact ; Dermatitis, Seborrheic ; Diagnosis ; Diagnosis, Differential ; Ear ; Eczema ; Female ; Forehead ; Fungi ; Humans ; Hyphae ; Lupus Erythematosus, Discoid ; Male ; Microsporum ; Nose ; Physicians, Primary Care ; Potassium ; Skin ; Tinea Capitis ; Tinea Pedis ; Tinea* ; Trichophyton

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A Study of Treatment and Compliance on Onychomycosis.

Yang Won LEE ; Moo Kyu SUH ; Kwang Hoon LEE ; Won Young HO ; Kyu Joong AHN ; Ki Hong KIM

Korean Journal of Medical Mycology.2005;10(3):83-90.

Onychomycosis is a common infection of the nail, with its prevalence estimated at 20 percent. However, a significant proportion of patients, perhaps as high as 20~40%, is classified as treatment failures and/or relapse following treatment. Several factors such as antifungal resistance, dermatophytoma, preexisting nail dystrophy, reinfection from the surrounding infected tissue can influence the success of a particular monotherapy. Therefore, the combination of antifungal drugs to produce synergistic activity is one possible advance towards achieving higher cure rates. The combination therapies have been known to increase antifungal spectrum and potency of drugs, facilitate drug delivery and reduce fungal load in nail plate. Their final goals are to increase a tolerance and maximize the therapeutic efficacy. Considering the special circumstance of the nail, the oral/topical combination is the most appropriate, for it increases drug concentration in the nail plate by mutual complementary cooperation. Treatment of onychomycosis requires long-term systemic medication of antifungal agent, and its complete cure rates were only 30~50%. Clinical success rate is determined by patients compliance which depends on treatment method and period. In practice, compliance of long-term treatment was very low, possibly attributable to longer treatment duration. Another challenge was relapse and/or reinfection after cure. The authors have attempted to address the issue concerning the method of treatment and duration of action for oral antifungal agents commonly used in practice today, and whether there is a statistically significant difference among those drugs, based on the studies analyzing patient compliance.
Antifungal Agents ; Compliance* ; Humans ; Onychomycosis* ; Patient Compliance ; Prevalence ; Recurrence ; Treatment Failure

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Infections Caused by Dematiaceous Fungi.

Moo Kyu SUH ; Yong Hwan LEE

Korean Journal of Medical Mycology.2005;10(3):77-82.

The dematiaceous fungi, characterized by having melanin in their cell walls, have become significant due to an increasing cause of human skin disease in Korea. The disease caused by dematiaceous fungi contain pityriasis (tinea) nigra, onychomycosis (in part), black piedra, keratomycosis (in part), chromoblastomycosis, phaeohyphomycosis, and eumycotic mycetoma (in part). Chromoblastomycosis is subcutaneous mycotic disease that contain sclerotic cells and histologically show pseudoepitheliomatous hyperplasia with microabscess, and phaeohyphomycosis is a group of mycotic infections that contain dematiaceous yeast-like cells, pseudohypae-like elements, hyphae or combination of these form in tissue.
Cell Wall ; Chromoblastomycosis ; Fungi* ; Humans ; Hyperplasia ; Hyphae ; Korea ; Melanins ; Mycetoma ; Onychomycosis ; Phaeohyphomycosis ; Piedra ; Pityriasis ; Skin Diseases

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A Case of Localized Skin Infection Due to Scedosporium apiospermum Diagnosed by DNA Sequencing of the Internal Transcribed Spacer Region.

Ji Young YOO ; You Bum SONG ; Moo Kyu SUH ; Gyoung Yim HA ; Jong Im LEE ; Seung Hyun SOHNG

Korean Journal of Medical Mycology.2014;19(2):45-51.

Scedosporium apiospermum is an asexual state of Pseudallescheria boydii which has been isolated from soil, sewage, and decaying vegetation. It can cause cutaneous infections by traumatic implantation of the contaminant due to penetrating injury. This ubiquitous fungus cause not only mycetoma, but also infections of variety of body sites including the skin. The localized skin infection due to this organism is much rare than mycetoma. We report a case of cutaneous S. apiospermum infection occurred in 80-year-old male. The skin lesion was manifested by a 8.0 x 4.0 cm-sized erythematous plaque with pustules and crusts on the dorsum of right hand. The fungal culture from the biopsy specimen on Sabouraud's dextrose agar showed white to gray colored cottony colonies of S. apiospermum. The nucleotide sequence of internal transcribed spacer for clinical isolate was identical to that of S. apiospermum strain IHEM 23829. The patient was treated with oral fluconazole for 3 months.
Agar ; Aged, 80 and over ; Base Sequence ; Biopsy ; Fluconazole ; Fungi ; Glucose ; Hand ; Humans ; Male ; Mycetoma ; Pseudallescheria ; Scedosporium* ; Sequence Analysis, DNA* ; Sewage ; Skin* ; Soil

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Clinical Study of Dermatophytosis Caused by Microsporum canis.

Seok Hwan JANG ; Sook Jung YUN ; Jee Bum LEE ; Seong Jin KIM ; Seung Chul LEE ; Young Ho WON

Korean Journal of Medical Mycology.2014;19(2):39-44.

BACKGROUND: Microsporum (M.) canis is a zoophilic dermatophyte commonly acquired from cats or dogs, and it is the most common pathogen of tinea capitis in Korea. An increase in the incidence of M. canis infection has been observed after 1970s. OBJECTIVE: To investigate the changes in epidemiological features and clinical findings on M. canis infection. METHODS: We retrospectively carried out an analysis of 133 patients with M. canis infection among clinically suspected dermatophytosis during last 10 years, from 2001 to 2010. RESULTS: The isolation rate of M. canis was 5.9% of all isolated dermatophytes. The annual number of patients infected by M. canis has fluctuated between 8 and 22 and was highest in 2007. The infections were most prevalent in patients under the age of 10 years (51.1%). The ratio of male to female patients was 0.8:1 in total, but 1.1:1 in children under the age of 10 years, and 0.4:1 in adults. Seasonally, 58.6% (78 cases) occurred in winter and spring, which was more prevalent than in other seasons. The highest clinical type among dermatophytosis was tinea capitis (56.4%), and followed by tinea faciale (15.8%), and tinea corporis (15.0%). The incidence of patients with the noninflammatory lesions (68.3%) in tinea capitis was higher than inflammatory lesions (31.7%) in clinical characteristics. CONCLUSION: We analyzed the patients with dermatophytosis caused by M. canis during last 10 years, from 2001 to 2010, and their prevalence, seasonal changes, and clinical charateristics were demonstrated and compared with previous studies.
Adult ; Animals ; Arthrodermataceae ; Cats ; Child ; Dogs ; Female ; Humans ; Incidence ; Korea ; Male ; Microsporum* ; Prevalence ; Retrospective Studies ; Seasons ; Tinea Capitis ; Tinea*

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Effectiveness of Home-use Light Emitting Diode Device for Seborrheic Dermatitis of the Scalp: a Preliminary Study.

Seung Myun KIM ; Seung Chul LEE ; Young Ho WON ; Jee Bum LEE

Korean Journal of Medical Mycology.2014;19(2):31-38.

BACKGROUND: Seborrheic dermatitis (SD) is a chronic, relapsing inflammatory disease, mainly affecting the scalp and face. The pathogenesis of SD has been not fully understood yet, but may be related to the skin colonization of Malassezia species, lipophilic yeasts. Phototherapy with light emitting diode (LED) device has been become a new therapeutic modality for some skin diseases such as acne. OBJECTIVE: To evaluate effectiveness and safety of phototherapy with home-use LED in the treatment of patients with SD of the scalp. METHODS: Eight patients with mild-to-moderate SD of the scalp participated. The patients used a home-use LED device combined 395 nm blue light with 660 nm red light for 6~7 min twice daily for 8 weeks. Patients' assessments were made by clinical findings including erythema (0~15), scales (0~15), itching (0~10), and lesional extent (0~15). And clinical photographs were taken at 0, 2, 4 and 8 weeks, respectively. RESULTS: At 8 weeks after LED treatment, erythema (7.75 to 5.13, p=0.018), scales (7.38 to 4.13, p=0.017), itching (6 to 3, p=0.011) and lesional extent (8.25 to 5.25, p=0.017) were significantly decreased, respectively. Satisfactory scores were also relatively high (mean 8.13 of 10). No severe adverse reaction was reported, excepting hair dryness (n=1) and brief stinging sense (n=1). CONCLUSION: Home-use LED was effective and safe in the treatment of SD of the scalp. These results suggest the LED device might be an adjuvant therapeutic tool in the treatment of Malassezia species associated diseases such as dandruff and SD. Further long-term and large-scale studies are required to assess the efficacy and safety of home-use LED.
Acne Vulgaris ; Bites and Stings ; Colon ; Dandruff ; Dermatitis, Seborrheic* ; Erythema ; Hair ; Humans ; Malassezia ; Phototherapy ; Pruritus ; Scalp* ; Skin ; Skin Diseases ; Weights and Measures ; Yeasts

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Efficacy of Trichloroacetic Acid in Patients with Toenail Onychomycosis: Pilot Study with 14 Patients.

Weon Ju LEE ; Kyung Hea PARK ; Chang Hyun SONG ; Seok Jong LEE ; Do Won KIM

Korean Journal of Medical Mycology.2014;19(2):25-30.

BACKGROUND: Various methods have been employed for treatment of onychomycosis. These methods can be categorized as topical, oral, or device-related. Among them, oral therapies have been regarded as the gold standard for treatment. However, the efficacy of oral therapies on onychomycosis remains limited and safety may be an issue, leaving many patients in need of alternative treatments. As an alternative treatment for onychomycosis, topical therapies are under investigation with great interest. OBJECTIVE: We conducted an investigation on the efficacy of trichloroacetic acid (TCA) as a new therapeutic option in treatment of onychomycosis. METHODS: Fourteen patients with onychomycosis in both great toenails, which was confirmed by fungal examination, were enrolled. About 0.1 ml of 100% TCA solution was applied on one great toenail of the patients eight times at an interval of one week. The other great toenail of the patients was treated with vehicle. RESULTS: At the end of the treatment period, clinical improvement of TCA-treated great toenails with onychomycosis was observed in eleven out of 14 patients. By contrast, no clinical improvement was observed in vehicle-treated great toenails with onychomycosis. Irritant contact dermatitis of the periungual nail folds occurred in 29% as an adverse effect. CONCLUSIONS: Topical solution of TCA may become a new therapeutic option for treatment of patients with onychomycosis who desire alternatives to oral antifungal agents.
Antifungal Agents ; Dermatitis, Contact ; Humans ; Nails* ; Onychomycosis* ; Pilot Projects* ; Trichloroacetic Acid*

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Chronic Recurrent Cutaneous Mucormycosis due to Rhizopus arrhizus.

Jae Bok JUN ; Kyung Duck PARK ; Soon Bong SUH

Korean Journal of Medical Mycology.2008;13(1):31-36.

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. It develops where a break in the integrity of the skin has occurred as a result of surgery, burn, or other forms of trauma. We report herein a case of primary cutaneous mucormycosis due to Rhizopus arrhizus in a 24-year-old healthy man without systemic illness, who developed recurrent, prograssively extending, weeping and tender swollen ulcerative patches at the artificial trauma site on the right side of his face since 9 years of age. It was successfully treated with amphotericin B ointment combined with oral itraconazole and ketoconazole.
Amphotericin B ; Burns ; Diabetes Mellitus ; Humans ; Itraconazole ; Ketoconazole ; Leukemia ; Lymphoma ; Mucormycosis ; Rhizopus ; Skin ; Ulcer ; Young Adult

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A Case of Onychomycosis Caused by Fusarium verticillioides.

Dong Nyeok HYUN ; Jong Hoon WON ; Joon Soo PARK ; Hyun CHUNG ; Jae Bok JUN

Korean Journal of Medical Mycology.2008;13(1):26-30.

Onychomycosis is caused by dermatophytes usually, but some species of non-dermatophytic molds and yeasts are also associated with invasion of nails. Fusarium (F.) verticillioides is a non-dermatophytic mold, which are common soil saprophytes. Onychomycosis due to Fusarium species almost always involves great toe nails and occurs infection easily in the presence of trauma, onychodystrophy and prior onychomycosis. We report a first case of onychomycosis caused by Fusarium verticillioides in a 48-year-old man. He presented with proximal white superficial onychomycosis for 3 months. Fungal culture showed whitish cottony colonies and microscopic examination of colonies showed microconidia in a chain from monophialide. We diagnosed onychomycosis caused by Fusarium verticillioides and treated by itraconazole 200 mg daily and 5% amorolfine nail lacquer for 3 months.
Arthrodermataceae ; European Continental Ancestry Group ; Fungi ; Fusarium ; Humans ; Itraconazole ; Lacquer ; Middle Aged ; Morpholines ; Nails ; Onychomycosis ; Soil ; Toes ; Yeasts

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Appropriate Condition of Germ Tube Formation as Presumptive Identification Test for Candida albicans.

Borae G PARK ; Mi Kyung LEE

Korean Journal of Medical Mycology.2008;13(1):20-25.

BACKGROUND: Candida albicans is the most prevalent species found in human yeast infections. The germ tube test is still frequently used for its rapid presumptive identification. Recently Candida dubliniensis as well as C. albicans has been reported to form germ tubes. OBJECTIVE: The purpose of this study was to evaluate the germ tube test at various conditions for rapid presumptive identification of C. albicans. METHODS: C. albicans ATCC 14053, C. albicans ATCC 18804, C. dubliniensis ATCC MYA 646, and C. dubliniensis KCTC 17427 were tested. Human pooled serum (HPS), HBV, HCV infected patient serum, fetal bovine serum (FBS) and rabbit serum (RS) were used for germ tube test. The germ tube formation was evaluated at different keeping condition of various sera, after mixing with 5 different bacterial suspensions and at various incubation conditions. RESULTS: The germ tube formation of C. albicans was more in the RS or FBS than in the HPS. For the various sera fresh sample was always the best expression of germ-tube forming ability. In the HCV infected patient serum and mixing with Pseudomonas aeruginosa germ tube formation was suppressed. C. dubliniensis did not form germ tube in the HPS, only formed in the FBS or RS. CONCLUSION: For rapid presumptive identification of C. albicans not C. dubliniensis the best selection of serum is the fresh HPS. We recommend the examination with isolated colony free from bacteria after incubation for 2 to 3 hours.
Bacteria ; Candida ; Candida albicans ; Humans ; Mya ; Pseudomonas aeruginosa ; Suspensions ; Yeasts

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