BACKGROUND: Onychomycosis and tinea pedis are common superficial fungal infections. Causative organism in onychomycosis and tinea pedis have been extensively studied, but the pathogenic role of non-dermatophyte is still controversial. Trichosporon species are soil and water-inhabiting yeasts, and occasionally found in the normal flora of human skin, mouth, and nails. Trichosporon spp. have been reported to be one of the pathogens in onychomycosis and tinea pedis. OBJECTIVE: We performed mycologic studies to investigate the prevalence and significance of trichosporon spp. in skin and nail lesions, which were clinically suspected of onychomycosis and tinea pedis. METHOD: We performed a survey of the mycologic laboratory records of patients clinically suspected of onychomycosis and tinea pedis from August 2001 to July 2002, and tried to identify trichosporon to species level by using API 20C kit systems. RESULTS: Out of total 1509 nail and skin samples examined, 663(43.9%) were culture positive. Trichosporon spp. were recovered from 11.2%(74/663) of the samples. In onychomycosis considered alone, the prevalence of solitary isolated Trichosporon spp. was 7.7%. In species level, T. asahii(62.1%), T. mucoides(20.3%), and T. inkin(14.9%) were isolated in decreasing frequency. The positive rate for KOH examination in trichosporon spp. was 52.9%. Among the isolated trichosporon spp., mixed cultures with other organisms were 13(17.6%) and solitary isolates were 61(82.4%). 31(41.9%) were not only positive for KOH examination but also founded in pure culture in relatively large colony counts. In pure culture isolations, high colony counts predominated over mixed cultures. CONCLUSION: Trichosporon spp. is a relatively common isolates from fungal cultures of skin and nail, and it may be pathogenic in some cases of skin or nail infection.
Humans ; Mouth ; Onychomycosis* ; Prevalence ; Skin ; Soil ; Tinea Pedis* ; Tinea* ; Trichosporon* ; Yeasts

Cutaneous larva migrans(CLM) is a creeping cutaneous eruption that results from skin invasion by the larval form of nematodes. We experienced two patients who had typical clinical findings of CLM. One patient had a history of contact with possibly contaminated fertilizer by the larva of nematotes. The other had a history of travelling to the endemic tropical areas. We report herein two cases of CLM with the literature review of the previous CLM cases in Korea.
Humans ; Korea ; Larva ; Larva Migrans* ; Skin

BACKGROUND: Skin cancer is one of the most preventable cancers by sun-protection and sunscreen is the most commonly used method of sun protection. OBJECTIVES: The aim of this study is to evaluate the awareness of harmful effects of sun exposure and behavior of sunscreen use in Korean. METHODS: One thousand, two hundred and seventy-four subjects who visited Dermatology Department at Asan Medical Center between April and July 2000 were interviewed. The questionnaire provided information about demographic characteristics, daily sun-exposure time, and sunburn history in the year before. It also included the questions about the causes of wrinkle, sunspot, chloasma, and skin cancer, as the awareness of the harmful effects of sun exposure. The use of sunscreen or other sun-protective methods, and the knowledge about sun protection factor (SPF) were also reported. RESULTS: The harmful effects of the sun in causing wrinkle, sunspot, chloasma, and skin cancer were conceived by 11.1%, 24.4%, 41.4%, and 44.3% of the respondents respectively. Thirty nine percent of the respondents used sunscreens, and the other 61% hardly knew necessity of sunscreens. Those who understood the meaning of sun protection factor(SPF) were 23.7%. Sun-protective methods except using sunscreens were use of a hat or a cap(53.2%), long-sleeved clothing(27.2%), a parasol(27.0%), heavy make-up(11.2%), and a towel(3.8%). Male respondents, people who were younger than 20 or older than 70, and those who had not sunburned the year before were less likely to use sunscreens. CONCLUSION: The results indicate an urgent need for education about the harmfulness of sun exposure as well as benefits of sunscreens.
Chungcheongnam-do ; Surveys and Questionnaires ; Dermatology ; Education ; Humans ; Male ; Melanosis ; Skin Neoplasms ; Solar Activity ; Solar System* ; Sun Protection Factor ; Sunburn ; Sunscreening Agents

BACKGROUND: Xanthelasma palpebrarum is the most common cutaneous xanthoma. Although xanthelasma is a type of xanthoma, a half of patients in most series are known to be normolipemic. OBJECTIVE: This study is an attempt to elucidate the clinical and pathologic features of xanthelasma in Korea and to know the clinical significance of xanthelasma, especially suggested role as a marker for hyperlipidemiae and increased risk for cardiovascular diseases. METHOD: Thirty seven cases of xanthelasma were clinially and pathologically analyzed. Incidence of abnomal lipid profiles and cardivascular diseases were compared with those of control group using logistic regression statistics. RESULTS: 1. The incidence of xanthelasma was 0.09% of the total number of dermatologic patients. 2. The ratio between male and female was 1: 1.8 and the mean age was 52.4 years (range;17-71 years). 3. Clinically, it typically presented as yellow or orange papules on the inner canthus of both upper eyelids. 4. The incidences of abnormal lipid profiles(hyperlipidemia and dyslipoproteinemia) are 42.4-44.0%. The levels of total cholesterol and low density lipoprotein-cholesterol were increased significantly. The incidence of the cardiovascular diseases was 16.2%, which was not statistically different from that of control group. 5. Histopathologic findings of 23 cases showed masses of foam cells in the upper dermis accompanied with sparse inflammatory cells and few giant cells. CONCLUSION: Xanthelasma seems to help to identify persons with abnormal lipid profiles which are risk factors of cardiovascular diseases and we recommand examination of lipid profiles in patients with xanthelasma.
Cardiovascular Diseases* ; Cholesterol ; Citrus sinensis ; Dermis ; Dyslipidemias ; Eyelids ; Female ; Foam Cells ; Giant Cells ; Humans ; Hyperlipidemias* ; Incidence ; Korea ; Logistic Models ; Male ; Risk Factors ; Xanthomatosis

Aquired fibrokeratoma is a rare, benign tumor which occurs most frequently on the fingers. Because of the digital predilection, a term of digital fibrokeratoma has been frequently used. We present here two cases of acquired fibrokeratoma occurring on the prepatellar area and the proximal nail bed which are unusual sites of this lesion. A skin-colored, hyperkeratotic tumor with finger-like projection was found on the prepatellar area of a 29-year-old man and a round pedunculated nodule was found on the proximal nail bed of second finger of a 74-year-old woman. Histopathologic examination revealed typical features of acquired fibrokeratoma.
Adult ; Aged ; Female ; Fingers ; Humans

Mucormycosis is a rare and opportunistic infection usually associated with hematologic diseases, diabetes mellitus, renal failure, solid tumors, and organ transplantations. We present here a considered case of disseminated mucormycosis in renal transplant recipient. A 60-year-old man who had undergone second kidney transplantation for a month visited emergency room due to 5 day history of cough with spiking fever and abnormal mental status and vital signs were rapidly deteriorated. Septic shock was suspicious. He was admitted to ICU and treated with broad spectrum antibiotics and antiviral agents, but there was no improvement. A few days later, several large hemorrhagic blisters and purpura occurred on the face, trunk, and both lower extremities. The histopathologic examination from skin specimen revealed large, broad, nonseptate hyphae branched at right angles in the dermis and blood vessels, which was consistent with mucormycosis. But the skin culture for fungus was negative. He had had no skin trauma history and evidence. So we considered the disseminated mucormycosis from unknown primary origin. He died of progressive respiratory failure before antifungal treatment.
Anti-Bacterial Agents ; Antiviral Agents ; Blister ; Blood Vessels ; Cough ; Dermis ; Diabetes Mellitus ; Emergency Service, Hospital ; Fever ; Fungi ; Hematologic Diseases ; Humans ; Hyphae ; Kidney Transplantation ; Lower Extremity ; Middle Aged ; Mucormycosis* ; Opportunistic Infections ; Organ Transplantation ; Purpura ; Renal Insufficiency ; Respiratory Insufficiency ; Shock, Septic ; Skin* ; Transplantation* ; Transplants ; Vital Signs

We report the first case of toenail onychomycosis caused by Trichosporon asahii in a 60-year old Korean man. The patient presented with a typical distal subungual onychomycosis. Direct microscopic examination of scrapings on the potassium hydroxide(KOH) preparation revealed fungal elements. On modified dermatophyte agar, the colony was white color and wrinkled, folded with furrows and convolutions and microscopic morphology showed long rectangular arthroconidia and lateral blastoconidia of trichosporon species. The fungus was identified as T. asahii using API 20C AUX (bioMerieux S.A., l'Etolile, France) kit.
Agar ; Arthrodermataceae ; Fungi ; Humans ; Middle Aged ; Nails* ; Onychomycosis* ; Potassium ; Trichosporon*

Hair follicle nevus is a very rare hair follicle tumor and should be differentiated from other hair follicle hamartomas, such as trichofolliculoma, dilated pore of Winer, pilar sheath acanthoma, and trichodiscoma. We describe a 4-year-old female patient who presented erythematous papule on the face that was histopathologically diagnosed as hair follicle nevus.
Acanthoma ; Child, Preschool ; Female ; Hair Follicle* ; Hair* ; Hamartoma ; Humans ; Nevus*

Multiple dermatofibromas are rare and their etiology is unknown. An association with immunosuppression or altered immunity including autoimmune disorders has been reported. The mechanism for the development of multiple eruptive dermatofibromas in the setting of immune disturbance remains unclear. We herein report four cases of multiple dermatofibromas, one of them is associated with immunosuppression.
Histiocytoma, Benign Fibrous* ; Immunosuppression

BACKGROUND: Toxic epidermal necrolysis(TEN) is the most dramatic and life-threatening cutaneous drug reaction. However, specific and effective treatment for TEN have not yet been identified. Recently several reports suggested that high dose intravenous immunoglobulin(IV Ig) treatment has produced good results in patients with TEN. OBJECTIVE: To analyze the efficacy and side effects of IV Ig in treatement of TEN. METHODS: Ten patients with clinicopathological diagnosis of TEN were treated with IV Ig(1.6-3.4g/kg), and clinical efficacy and side effects were observed. RESULTS: Nine patients were healed and one died of sepsis. Interruption of further epidermal detachment occurred after an average 3 days from the onset of IV Ig therapy. Complete wound healing occurred after an average of 14.3 days. The side effects of IV Ig including headache, myalgia, nausea, transient neutropenia, and coombs positive hemolytic anemia were observed in 4 patients but normalized after cessation of IV Ig therapy. Three of them showed complete healing of detached skin but died with aggravation of underlying disease. CONCLUSION: IV Ig therapy represents a safe and very effective treatment for TEN. Furthermore, intensive care for underlying diseases is also very important for reducing the mortality rate in patients with TEN.
Anemia, Hemolytic ; Diagnosis ; Headache ; Humans ; Immunoglobulins* ; Critical Care ; Mortality ; Myalgia ; Nausea ; Neutropenia ; Sepsis ; Skin ; Stevens-Johnson Syndrome* ; Wound Healing