Onychomycosis is one of the most common diseases of the nails caused by dermatophytes, yeasts, and non-dermatophytic molds. Among the onychomycosis, tinea unguium occurred by dermatophytes such as Trichophyton rubrum, Trichophyton mentagrophytes, and Epidermophyton floccosum. Treatment options of onychomycosis include oral and topical antifungal agents, surgery or a combination therapy of theses modalities. The complete remission of onychomycosis requires long-term treatment with systemic and topical antifungal agents and recurrences and re-infections are common. In this review, we provide insights on the topical antifungal agents in onychomycosis and introduce new topical antifungal agents.
Antifungal Agents ; Arthrodermataceae ; Epidermophyton ; Fungi ; Onychomycosis* ; Recurrence ; Trichophyton ; Yeasts

AIM: To isolate new and/or bioactive constituents from EtOAc extract of liquid culture of endophyte Guignardia sp. from the leaves of Undaria pinnatifida (Harv.) Sur. METHODS: Isolation and purification were performed through silica gel column chromatograph, Sephadex LH-20 and reversed-phase ODS column and the structures of the compounds obtained were identified through a combination of spectral and chemical methods (IR, MS, (1)H and (13)C NMR). In vitro bioactive assays including antifungal activity against three human pathogenic fungi Microsporum canis, Tricophyton rubrum and Epidermophyton floccosom and cytotoxic activity against the human nasopharyngeal epidermoid tumor KB cell line were evaluated. RESULTS: Seven compounds have been obtained from the liquid culture of the title endophyte: ergosterol peroxide (6, 22-diene-5, 8-epidioxyergosta-3-ol) (1), ergosterol (2), cyclo-(Tyr-Leu) (3), cyclo-(Phe-Phe) (4), cyclo-(Val-Leu) (5), cyclo-(Phe-Pro) (6) and cyclo-(Leu-Ile) (7). Compounds 1-3 and 6 inhibited the growth of M. canis with MICs of 10.0, 20.0, 50.0 and 5.0 μg·mL(-1), respectively and compounds 1, 2 and 6 against T. rubrum with MICs of 15.0, 20.0 and 10.0 μg·mL(-1), respectively and 1 and 6 against E. floccosom with MICs of 20.0 and 50.0 μg·mL(-1), respectively. In addition, compounds 1, 3 and 6 exhibited cytotoxic activity against KB cell line with IC(50) of 20.0, 10.0, 10.0 μg·mL(-1), respectively. CONCLUSION Compounds 1-7 were obtained from Guignardia sp. of U. pinnatifida for the first time, and compounds 1 and 6 had potent cytotoxic and antifungal activity.
Antifungal Agents ; chemistry ; isolation & purification ; pharmacology ; Antineoplastic Agents ; chemistry ; isolation & purification ; pharmacology ; Ascomycota ; chemistry ; metabolism ; Biological Products ; chemistry ; pharmacology ; Carcinoma, Squamous Cell ; drug therapy ; Cell Line, Tumor ; Endophytes ; Epidermophyton ; drug effects ; Humans ; Inhibitory Concentration 50 ; Microbial Sensitivity Tests ; Microsporum ; drug effects ; Nasopharyngeal Neoplasms ; drug therapy ; Phytotherapy ; Plant Leaves ; microbiology ; Undaria ; microbiology

BACKGROUND: There have been many studies about concurrent infection with tinea cruris and tinea pedis as a part of dermatophytosis in Korea. However, few studies have been reported about actual percentage regarding the frequency of tinea pedis in patients with tinea cruris and comparison of the causative organisms in the groin and foot. OBJECTIVE: The purpose of this study was to investigate the frequency of tinea pedis in patients with tinea cruris and the causative organisms in the groin and foot. METHODS: We examined clinical characteristics, frequency of tinea cruris, and causative organism on one hundred and eight nine cases with tinea cruris at the department of dermatology, Dongguk University Hospital from September 2000 to August 2005. RESULTS: The ratio of male to female patients was 10.8:1. Besides most of them were between the twenties and forties. Most (74.6%) of them involved both sites of the groin. Duration of tinea cruris was the most common within one year. The frequency of tinea pedis in patients with tinea cruris was 85.7%. Most of them (69.1%), duration of tinea pedis was longer than that of tinea cruris. One hundred and thirty nine dermatophytes were isolated from 189 patients with tinea cruris. They were Trichophyton(T.) rubrum (89.2%), T. mentagrophytes (7.2%), and Epidermophyton floccosum (3.6%). Of one hundred and sixty two patients with both tinea cruris and tinea pedis, 52 patients (32.1%) had same species and only four patients (2.5%) had different species in the groin and foot. CONCLUSION: Because of the high incidence of concurrent infection with tinea cruris and tinea pedis, we suggest the need of a careful mycological examination for foot in patients with tinea cruris.
Arthrodermataceae ; Dermatology ; Epidermophyton ; Female ; Foot ; Groin ; Humans ; Incidence ; Korea ; Male ; Tinea Pedis* ; Tinea*

Antifungal activities of clove essential oil and its volatile vapour against dermatophytic fungi including Candida albicans, Epidermophyton floccosum. Microsporum audouinii, Trichophyton mentagrophytes, and Trichophyton rubrum were investigated. Both clove essential oil and its volatile vapour strongly inhibit spore germination and mycelial growth of the dermatophytic fungi tested. The volatile vapour of clove essential oil showed fungistatic activity whereas direct application of clove essential oil showed fungicidal activity.
Candida albicans ; Clove Oil ; Epidermophyton ; Syzygium* ; Fungi* ; Germination ; Microsporum ; Spores ; Trichophyton

Superficial cutaneous mycosis is mycotic infection of the epidermis of the skin, and one of common dermatoses in Korea. They have close relationship between host (human) and fungi. Their clinical patterns and incidence, and their causative fungi may change with social environments and life patterns. Since 1945, GNP has been increased explosively, more than 243 folds, and economic developments brought abrupt changes of social environments and life patterns in Korea. Furthermore, there had been great social events during this period; Korean War in 1950-1953, the Asian Game in 1986, the Olympic Game in 1988 and the World Cup in 2002. Those events gave much chances for dermatophytes to move and change. Tinea pedis is the most common dermatophytosis and has been increased from 26% of all dermatophytosis in late 1950s to 40.9-42.2%. And tinea unguium(onychomycosis) has been increased as tinea pedis does; Its proportion was 2.8% in late 1950s, and 17% in 1990s. The patients with tinea pedis have high family infection rate and also have high coexisting dermatophytosis. The most common isolate was Trichophyton(T.) rubrum, followed by T. mentagrophytes and Epidermophyton floccosum. Tinea capitis showed the most dramatic changes; its incidence was the highest just after Korean war and decreased abruptly since 1970s. Microsporum(M.) ferrugineum was the most common isolates till 1970s, and abruptly decreased and now nearly disappeared. Trichophyton(T.) violaceum was isolated in Cheju island. After Korean war, T. schoenleinii was isolated from favus and is disappeared. M. canis was isolated for the first time in 1959 and has been the most common isolates since late 1970s. T. verrucosum was isolated in 1986, and T. tonsurans was isolated for the first time in 1995 and spread among wrestlers, Judo players and Korean wrestlers. It might be imported by wrestlers with sport exchanging program. In cidence of tinea cruris was dramatically changed and was 5% of all dermatophytosis in 1940s, and 26.6-39.1% in 1990s. Those changes might be related to change of life patterns. Proportion of cutaneous candidiasis among superficial cutaneous mycosis was 1.9% in 1960s, 6.7% in 1973, 14.6% in 1976-1985, and 7.4% in 1989-1992. Proportion of pityriasis versicolor among superficial cutaneous mycosis was 12.1% in 1973, 7.7% in 1976-1985, and 7.7% in 1989-1992. Research for Malassezia have been increasing since late 1990s and that will bring us many new informations.
Arthrodermataceae ; Asian Continental Ancestry Group ; Candidiasis, Cutaneous ; Climacteric ; Epidermis ; Epidermophyton ; Fungi ; Humans ; Incidence ; Jeju-do ; Korea* ; Korean War ; Malassezia ; Martial Arts ; Mycoses* ; Skin ; Skin Diseases ; Social Change ; Social Environment ; Sports ; Tinea ; Tinea Capitis ; Tinea Favosa ; Tinea Pedis ; Tinea Versicolor

Deramtophytosis is one of common dermatoses and occupied 10~20% of all dermatologic outpatients in Korea. It has close relationship between host (human) and dermatophytes. Their clinical patterns and incidence, and their causative dermatophytes may change with social environments and life patterns; Some dermatophytes may decrease or disappear and others can be imported from other countries. During recent 60 years, GNP has been increased explosively, more than 190 folds, and that economic developments brought abrupt changes of social environments and life patterns in Korea. Furthermore, there had been great social events; Korean War in 1950~1953, the Asian Game in 1986, the Olympic Game in 1988 and the World Cup in 2002. Those events gave much chances for dermatophytes to move and change. Trends of clinical types of dermatophytosis and their causative dermatophytes were evaluated with reported articles during the period. Tinea capitis showed the most dramatic changes. Its incidence was the highest just after Korean war, 24.5% of all primary school students, and decreased abruptly by 26.5% of all dermatophytosis in late 1950s, 4.9% in late 1960s, and 2~4% since 1970s. Microsporum(M.) ferrugineum was the most common isolates till 1970s, and abruptly decreased and now nearly disappeared. Trichophyton(T.) violaceum was isolated in Cheju island. After Korean war, T. schoenleinii was isolated from favus and disappeared. M. canis was isolated for the first time in 1959 and has been the most common isolates from tinea capitis since late 1970s. T. verrucosum was isolated for the first time in 1986 in Kwangju and has been isolated nation-widely. T. tonsurans was isolated for the first time in 1995 in Daegu and spread among wrestlers, Judo players and Korean wrestlers. It might be imported by wrestlers with sport exchanging program. Tinea pedis is the most common dermatophytosis in Korea now. It was 26% of all dermatophytosis in late 1950s, and increased by 40.9~42.2% in 1970s. And tinea unguium has been increased as tinea pedis does; It was 2.8% of all dermatophytosis in late 1950s, and increased by 5.1~14.2% in 1970s, 5.5~15.3% in 1870s and 17% in 1990s. The patiets with tinea pedis have high family infection and also high coexisting dermatophytosis. The most common isolate was T. rubrum, followed by T. mentagrophytes and Epidermophyton floccosum. Tinea cruris was one of dramatically changed dermatophytosis. Its incidence was 5% of all dermatophytosis in 1940s, and increased by 10.2% in late 1950s, and 26.6~39.1% in 1970s. Environments and socioeconomic conditions are changing, and international travel and sports exchanging program are increasing. All those social events may cause new dermatophytes to invade from other countries. We should check it carefully and continuously.
Arthrodermataceae ; Asian Continental Ancestry Group ; Daegu ; Epidermophyton ; Gwangju ; Humans ; Incidence ; Jeju-do ; Korea* ; Korean War ; Martial Arts ; Onychomycosis ; Outpatients ; Skin Diseases ; Social Change ; Social Environment ; Sports ; Tinea Capitis ; Tinea Favosa ; Tinea Pedis ; Tinea*

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

Dermatophytes are keratinophilic fungi responsible for superficial infections called dermatophytoses and composed of three anamorphic genera, Trichophyton, Microsporum and Epidermophyton. The identification of these species by mycological methods is sometimes difficult and time-consuming. Moreover, suitable methods for subtyping of these species are not established yet. Therefore, several approaches using molecular biological methods have been proposed to identify dermatophyte species and to clearly define their taxonomic and phylogenetic relationship to the teleomorphs and to other dermatophyte species. For identification, distinction among isolates to the species level was easily performed using molecular biological methods, particularly for atypical isolates. In contrast, in all but a few cases, distinction between dermatophyte strains failed. The development of new techniques to reveal molecular polymorphisms in dermatophytes is required.
Arthrodermataceae* ; Epidermophyton ; Fungi ; Microsporum ; Molecular Biology ; Tinea ; Trichophyton

BACKGROUND: The prevalence and clinical characteristics of dermatomycosis are changed under the various influences such as geographic factor, social environment and development of therapy. OBJECTIVE: The purpose of this study was to evaluate the present status of dermatomycosis and changes on the prevalence, sex and age distribution and causative organisms. METHODS: We performed clinical and mycological studies on 7,568 cases of dermatomycosis among outpatients of Dermatologic clinic of Chonnam University Hospital for 10 years, from January 1991 to December 2000. RESULTS: The incidence of dermatomycosis was 17.6% of out-patients and show the highest incidence in the fourth decades (18.8%). The ratio of male to female was 1.3:1, showing slightly male-predominant pattern. The incidence of Tinea pedis (28.9%) was the highest, followed by Onychomycosis (16.3%), Tinea corporis (11.2%), Tinea cruris (10.1%), Tinea versicolor (9.3%), Tinea manus (8.0%), Candidiasis (6.9%), Tinea faciale (5.5%) and Tinea capitis (3.2%). Coexisting fungal infections were found 846 patients (11.2%) and the cases of Tinea pedis with onychomycosis were the most common. The positive rate of KOH examination was 50.8% and the positive rate of culture on Sabouraud's dextrose agar media was 31.4%. Trichophyton(T.) rubrum was the most common causative organism of dematomycosis (67.7%), followed by Candida albicans (13.0%), Microsporum(M.) canis (9.9%), T. mentagrophytes (7.4%), Epidermophyton floccosum (0.5%), M. gypseum (0.5%), T. verrucosum (0.4%), T. tonsurans (0.3%) and T. violaceum (0.2%). CONCLUSION: Compared with previous studies, the incidence of dermatomycosis increased, especially in females and was evenly distributed throughout all ages. The frequency of tinea pedis and tinea cruris decreased, but increased in onychomycosis.
Agar ; Age Distribution ; Candida albicans ; Candidiasis ; Dermatomycoses* ; Epidermophyton ; Female ; Geography ; Glucose ; Humans ; Incidence ; Jeollanam-do ; Male ; Onychomycosis ; Outpatients ; Prevalence ; Social Environment ; Tinea ; Tinea Capitis ; Tinea Pedis ; Tinea Versicolor

BACKGROUND: Superficial fungal disease is one of the most common human infectious diseases. A recent clinical survey reported that more than half of patients with superficial fungal diseases might be infected at home. OBJECTIVE: The aim of this study is to investigate the correlation of the fungal infection between the patients and their family members. METHODS: Dermatologists of 71 general hospitals were involved and evaluated 7,323 patients and 1,037 their family members who were confirmed microscopically to have superficial fungal diseases. RESULTS: According to the survey results, 46.1% of the patients answered they might have been infected at home and 33.6% of the patients remembered there were other fungus-infected patients among their family members at the same time. The isolated organisms were Trichophyton rubrum (1686 cases, 80.9%), Trichophyton mentagrophytes (269 cases, 12.9%), Candida albicans (112 cases, 5.4%), Microsporum canis (12 cases, 0.6%), Trichophyton tonsurans (3 cases, 0.1%), Epidermophyton floccosum (2 cases, 0.1%). On the basis of the fungus culture, it was proven that 85.4% of the patients and their family members had the same kind of microorganism. CONCLUSION: As a result, we could conclude that there is a high possibility of transmitting the fungal infection from one family member to another.
Candida albicans ; Communicable Diseases ; Epidemiology* ; Epidermophyton ; Fungi ; Hospitals, General ; Humans ; Korea* ; Microsporum ; Trichophyton