Interleukin-17 (IL-17) is secreted by a class of helper T cells called Th17 cells, which stimulates keratinocytes to secrete proinflammatory mediator and to recruit other inflammatory cells in psoriatic skins. IL-17A inhibitor was approved for the management of psoriatic arthritis by FDA. It is the one of the biologics approved as first-line therapy for the management of psoriasis. But several studies show some side effects of IL-17A inhibitor such as upper respiratory infection and fungal infection like Candida albicans. Herein we report a widespread dermatophytosis during IL-17A inhibitor treatment. A 66-year-old male patient, with tinea unguium and chronic plaque psoriasis for several decades, presented with multiple erythematous scaly macules and patches for 2 weeks. He medicated IL-17A inhibitor for treating psoriasis total 3 times and last injection was 1 week ago. Dermatological examination revealed the involvement of 20% body surface area in the form of erythematous scaly macules and patches. KOH mount revealed the presence of numerous hyphae. The patient was started on oral terbinafine, topical isoconazole and efinaconazole. His skin lesions were improved after 1 month of anti-fungal therapy. IL-17 plays an important role in mucocutaneous microbial defense. So, fungal infection should be checked in using IL-17A inhibitor patients periodically.

Patients presenting with green nail syndrome often show coinfection with fungus. A delay in the accurate diagnosis of coinfection may warrant longer treatment duration. Four patients with green nail syndrome coinfected with fungus were reviewed retrospectively. Fungal culture, cultivating Candida parapsilosis and Candida albicans, was performed in two patients' samples. The mean time of the initiation of treatment for onychomycosis after the first visit was 5.75 weeks. If green nail syndrome is suspected, screening for fungal coinfections and precise management are necessary.

BACKGROUND: Several studies about bee venom components have reported anti-fungal, anti-inflammatory, and anti-cancer effects. Malassezia species are components of skin flora, and also associated with many dermatologic diseases such as seborrheic dermatitis, pityriasis versicolor, folliculitis, and atopic dermatitis. OBJECTIVE: To investigate the antifungal activity of bee venom components, melittin, and apamin, against Malassezia strains. METHODS: With 10 Malassezia species, minimal inhibitory concentrations (MICs) were tested with bee venom, and Zinc pyrithione as a reference antifungal agent. RESULTS: Whole bee venom, melittin, and apamin did not show any antifungal activity against Malassezia species at the concentrations tested. CONCLUSION Although bee venom do not have anti-Malassezia activities, it is known to have antifungal activities against other fungal strains. Therefore, further study should consider revealing the mechanism of antifungal activity against fungus and other possible target strains of fungi.

Onychomycosis is a fungal nail infection caused mainly by dermatophytes. Non-dermatophytes such as yeasts, Acremonium, Aspergillus, and Fusarium species account for only 10% of onychomycosis, and Fusarium species are relatively common amongst these pathogens. However, the main Fusarium species pathogens are Fusarium solani and Fusarium oxysporum. Fusarium proliferatum is a rare pathogen in onychomycosis, and only a few cases have been reported worldwide. We report a case of a 68-year-old woman presenting with a white- to yellow-colored patch on her left third fingernail plate, which was diagnosed by fungus culture and sequencing as onychomycosis caused by Fusarium proliferatum.

Purpureocillium is a genus of saprophytic fungi that is commonly found in soil or rotting material. Although rarely a pathogen in humans, it can cause serious infections in immunocompromized patients. An 85-year-old woman presented with a 2-week history of pruritic erythematous plaques with yellowish crusts on her right forearm and dorsal hand. Histopathological analysis identified fungal hyphae and spores in the dermis, and Purpureocillium lilacinum was identified through tissue culture, polymerase chain reaction, and DNA sequencing. The skin lesion barely responded to 4 weeks of itraconazole treatment but improved upon the addition of terbinafine. The skin lesion was completely cured after 12 weeks, with no recurrence to date. Here, we report a rare deep cutaneous fungal infection caused by P. lilacinum in an immunocompetent patient and postulate that, in this case, the patient's agricultural lifestyle increased the possibility of P. lilacinum infection.

BACKGROUND: Sporotrichosis is a common deep mycosis caused by the Sporothrix schenckii complex. Until 2016, no molecular studies had been conducted on these fungi, and all the included strains were reported as S. schenckii. However, investigations conducted in northeast China, Japan, and India revealed that S. globosa was the most prevalent Sporothrix species, whereas S. schenckii sensu stricto was reported very rarely. OBJECTIVE: To investigate the accurate prevalent causative species of sporotrichosis among strains reported as S. schenckii in Korea. METHODS: We isolated strains of Sporothrix spp. Prevalent in Korea from fungus collection centers or private collections and reviewed the available literature on molecular studies of strains from this region. We found five S. schenckii (1998-2016) and three S. globosa (2016-2018) strains. Ribosomal DNA internal transcribed spacer (ITS) sequences of these strains were compared with those of the S. schenckii complex strains. RESULTS: The ribosomal ITS sequences of the eight strains were 100% identical with that of S. globose. No S. schenckii sensu stricto was found. In addition, a study on the molecular analysis of Korean S. schenckii published by Ishizaki et al. (2004) demonstrated that the eight strains were of the mitochondrial subtype group B (S. globosa). Thus, all the 16 strains examined within the Korean S. schenckii complex were determined to be S. globosa. CONCLUSION In summary, S. globosa is the causative species within the tested Korean sporotrichosis cases reported between 1998 and 2018. Based on our analyses, S. globosa, and not S. schenckii, may be the predominant species in Korea.