BACKGROUND: Hepatitis B virus (HBV) infection leads to hepatic and extrahepatic manifestations including chronic kidney disease (CKD). However, the association between HBV and CKD is not clear. This study investigated the association between chronic HBV infection and CKD in a nationwide multicenter study. METHODS: A total of 265,086 subjects who underwent health-check examinations in 33 hospitals from January 2015 to December 2015 were enrolled. HBV surface antigen (HBsAg) positive cases (n = 10,048), and age- and gender-matched HBsAg negative controls (n = 40,192) were identified. CKD was defined as a glomerular filtration rate (GFR) < 60 mL/min/1.73 m² or proteinuria as at least grade 2+ of urine protein. RESULTS: HBsAg positive cases showed a significantly higher prevalence of GFR < 60 mL/min/1.73 m² (3.3%), and proteinuria (18.9%) than that of the controls (2.6%, P < 0.001, and 14.1%, P < 0.001, respectively). In the multivariate analysis, HBsAg positivity was an independent factor associated with GFR < 60 mL/min/1.73 m² along with age, blood levels of albumin, bilirubin, anemia, and hemoglobin A1c (HbA1c). Likewise, HBsAg positivity was an independent factor for proteinuria along with age, male, blood levels of bilirubin, protein, albumin, and HbA1c. A subgroup analysis showed that HBsAg positive men but not women had a significantly increased risk for GFR < 60 mL/min/1.73 m². CONCLUSION: Chronic HBV infection was significantly associated with a GFR < 60 mL/min/1.73 m² and proteinuria (≥ 2+). Therefore, clinical concern about CKD in chronic HBV infected patients, especially in male, is warranted.
Anemia ; Antigens, Surface ; Bilirubin ; Case-Control Studies* ; Female ; Glomerular Filtration Rate ; Hepatitis B Surface Antigens ; Hepatitis B virus ; Hepatitis B, Chronic* ; Hepatitis, Chronic* ; Humans ; Male ; Multivariate Analysis ; Prevalence ; Proteinuria ; Renal Insufficiency, Chronic*

Microsporum (M.) ferrugineum has almost disappeared in Korea after three cases of tinea capitis that were reported in Jeonbuk province in 1993. It was most common cause of tinea capitis in Korea until 1970s. M. ferrugineum produces abundant chlamydospores. Another characteristic of the species is the production of distorted faviform hyphae and long, straight hyphae with thick septa that resemble segments of bamboo. We report a case of 27-year-old female with tinea corporis caused by M. ferrugineum.
Adult ; Female ; Humans ; Hyphae ; Korea ; Microsporum ; Tinea ; Tinea Capitis

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

BACKGROUND: Sporotrichosis is a subacute to chronic, deep fungal infection caused by Sporothrix schenckii and has a wide variety of clinical presentations. Although sporotrichosis is the most common deep fungal infection in Korea, few reports have included a long term investigation and survey of sporotrichosis. OBJECTIVE: We analyzed patients' records for 38 recent years to identify the incidence and changes in clinical findings on sporotrichosis. METHODS: We conducted a retrospective analysis of 71 patients with sporotrichosis for 38 recent years (1968~2005) by reviewing the medical records and making phone calls to patients if needed. RESULTS: The incidence of sporotrichosis is currently on a decreasing trend and incidents were more common for rural residents (43 cases, 60.6%) than urban residents (28 cases, 39.4%). The most frequent occupation of patients was 'farmer' (37 cases, 52%). Seasonally, twenty seven cases (38.0%) occurred in winter (December to February), showing higher incidence than any other season. Lympho-cutaneous type (53 cases, 74.6%) is more common than fixed cutaneous type (18 cases, 25.4%) and the most common site of the initial lesion was left upper extremity. Of 47 patients who had primary lesion on upper extremity, 39 (83%) were of the lympho-cutaneous type, and of 15 patients who had primary lesion on face, 9 (60%) were of the fixed cutaneous type. CONCLUSION: According to this study, some changes in clinical findings and prevalence of sporotrichosis over the study period were noted. Further observation and analysis are required to clarify the meaning of these changes.
Humans ; Incidence ; Korea ; Medical Records ; Occupations ; Prevalence ; Retrospective Studies ; Seasons ; Sporothrix ; Sporotrichosis ; Upper Extremity

Alternaria is a common saprophyte that is not usually pathogenic in humans. However, infections by the fungus have occasionally been documented, occurring mostly in immunocompromised patients. We report a case of cutaneous alternariosis caused by Alternaria alternata in a 64-year-old woman presenting with a coin-sized, slightly elevated, dark red plaque on the right wrist without systemic immunosuppression. Macroscopic and microscopic morphology of fungal culture and histopathological differentiation offered diagnostic possibility. Systemic roxithromycin and itraconazole were administered with a dramatic resolution of the lesion.
Alternaria* ; Alternariosis* ; Female ; Fungi ; Humans ; Immunocompromised Host ; Immunosuppression ; Itraconazole ; Middle Aged ; Roxithromycin ; Wrist

BACKGROUND: Tinea barbae(TB) is a rare dermatophytosis localized on the bearded areas of the face and neck. OBJECTIVE: The purpose of this study was to elucidate the epidemiological, clinical and mycological characteristics of TB. METHODS: During the 24-year-period from 1983 to 2004, 74 patients with TB were evaluated in regard to annual incidence, the distribution of the subjects according to age, season, involved site, occupation, a place of residence and concurrent fungal infection. Patients with TB were further assessed concerning causative agents by fungal culture and their association with clinical type and a place of residence. RESULTS: In epidemiologic aspect, annual incidence was increased until 1989, thereafter gradually decreased. TB showed peak incidence in April in monthly distribution. TB occurred predominantly in middle-aged adults, especially in fifties in age distribution and countryfolk in residential distribution. In clinical aspect, superficial type was the most common in clinical types, followed by follicular and kerion type. Upper lip was affected mostly. In mycologic aspect, fungal culture showed positive results in 57 patients. Trichophyton(T.) rubrum was the most common causative agents followed by T. mentagrophytes and T. verrucosum. Thirty six patients had concurrent fungal infection and tinea pedis was the most common. CONCLUSION: The result suggests that although the incidence of TB is decreasing, it is important not only to isolate cattle with dermatophytoses from people but also to treat concurrent dermatophytoses in order to decrease the incidence
Adult ; Age Distribution ; Animals ; Cattle ; Epidemiologic Studies* ; Humans ; Incidence ; Lip ; Neck ; Occupations ; Seasons ; Tinea Pedis ; Tinea*

BACKGROUND: Trichophyton verrucosum (T. verrucosum) is a zoophilic dermatophyte distributed all around the world. In Korea, kerion celsi caused by T. verrucosum was first reported by Kim et al in the southeast province of Korea. Since then, many patients infected with T. verrucosum have been reported in Young-nam, Chungcheong province, and so on. OBJECTIVE: There have been few reports on the T. verrucosum in Korea, yet. Authors tried to offer the information on dermatophytosis due to T. verrucosum in the various aspects such as prevalence of each year, epidemiology, onset time of the year and season, distribution and characteristics of the regions, sex and age distribution, the clinical types, onset site of the body, and the relation between human beings and infected cattle and so on. METHOD: A total of 218 patients who visited Catholic Dermatologic Clinic in Daegu, Korea from 1986 to 2004, were finally diagnosed as T. verrucosum infection by KOH and fungal culture. The data were based on a retrospective survey of hospital records. However, whenever the information was lacking, we called patients to ask lists of questions for the investigation. RESULTS: The number of patients had increased every year since the first report in 1986. In 1988, the number was up to 44, which was the most. After the year 2000, the number of patients had been decreasing so continuously that there was no case in the year 2003 and 2004. As we see the distribution of province, 47 cases were from Daegu, 137 cases from Kyungsang bukdo, 29 cases from Kyungsang namdo, 5 cases from other provinces and cyties. In the distribution of season, 81 cases appeared in the spring, which was the most. Female to male ratio showed about a 1.2-fold predominance for male. And less than 15-year-old group was 41.3% of total patients. The most frequent onset site was face (36 cases, 16.5%), and the next were arm, trunk, head, leg, neck in the decreasing orders. Classifying the patients by the clinical type, 150 cases (68.8%) were in the tinea circinata type, and the next were kerion celsi type, tinea barbae type, agminated folliculitis type in the decreasing orders. Among 126 cases, 99 patients raised cattle with lesions caused by T. verrucosum, 8 patients raise cattle without lesions, 19 patients didn't breed cattle. CONCLUSION: This investigation is expected to help understand and obtain more information on T. verrucosum infection in Korea.
Adolescent ; Age Distribution ; Animals ; Arm ; Arthrodermataceae ; Cattle ; Daegu ; Epidemiology ; Female ; Folliculitis ; Head ; Hospital Records ; Humans ; Korea ; Leg ; Male ; Neck ; Prevalence ; Retrospective Studies ; Seasons ; Tinea ; Tinea Capitis ; Trichophyton*

BACKGROUND: Otomycosis is a mycotic disease of the external auditory meatus. Aspergillus is the most common pathogen. Despite the fact that a great number of fungi are considered as the cause of otomycosis, otomycosis due to dermatophytes occurs with great rarity. OBJECTIVE: The purpose of this study was to investigate clinical and mycological features of dermatophytosis in the external auditory meatus. METHODS: We performed a clinical and mycologic analysis of 17 patients who had been clinically and mycologically diagnosed with dermatophytosis of the external auditory meatus. In addition, amplication of TRS-1 and TRS-2 of the ribosomal DNA nontranscribed spacer was performed on strains of Trichophyton (T.) rubrum and T. raubitshcekii which were isolated from skin lesions of the external ear and cerumen in 6 patients. RESULTS: The ratio of male to female patients was 1.4:1. The age of patients were 6 to 72 and mean age of onset is 36.4. Eleven patients had concomitant dermatophytosis of other sites. Tinea unguium was combined in 7 cases, tinea pedis in 4 cases, tinea corporis in 3 cases, tinea manus in 2 cases and tinea cruris in 1 case. The positive rate of KOH examination was 88.2% and the positive rate of fungal culture on PDAC media was 88.2%. The most common organism cultured was T. rubrum (80.0%), followed by T. raubitschekii (13.3%) and T. mentagrophytes (7.7%). Ten patients were treated with topical terbinafine and seven patients with oral itraconazole, so all patients were cleared of fungi from the external auditory meatus and inflammation was resolved. With TRS-1 and TRS-2 amplication, 4 of 5 pairs of T. rubrum and 3 strains of T. raubitshcekii showed the same types regardless of the site in each patient. CONCLUSION: Dermatophytosis occurs rarely in the external auditory meatus but we experienced 17 cases of dermatophytosis at this site. With suspected otomycosis, dermatophytosis of the external auditory meatus and concomitant dermatophytosis must be investigated and treated simultaneously to prevent any recurrence.
Age of Onset ; Arthrodermataceae ; Aspergillus ; Cerumen ; DNA, Ribosomal ; Ear, External ; Female ; Fungi ; Humans ; Inflammation ; Itraconazole ; Male ; Onychomycosis ; Otomycosis ; Recurrence ; Skin ; Tinea Pedis ; Tinea* ; Trichophyton

BACKGROUND: Trichophyton (T.) tonsurans infection has been increasing gradually in non-athletes, i.e. general population as well as athletes since it was first reported that athletes had been infected in Korea in 1995, whereas it is a common dermatophyte species in the United States and Europe. OBJECTIVE: We performed retrospective study to observe tinea infections caused by T. tonsurans. METHOD: The clinical and epidermiological study was made with 105 patients of T. tonsurans infection among out-patients in our skin clinic from March, 1995 to December, 2003. RESULT: In 105 cases of T. tonsurans infection 73 ones were athletes such as wrestlers and judo players, and 32 ones were non-athletes. The infected skin lesions of 114 cases showed mild to moderate inflammation, whereas 7 ones showed moderate to severe inflammation. The results of KOH wet mount were positive in 92 cases (87.6%). In fungal culture with Potato dextrose agar-corn meal-tween 80, the mahogany variety (53.3%) was more than the sulfreum one (22.8%), which was less significant because the percentage of unclassified cases (23.8%) influenced on variety distribution considerably (p> 0.05, chi-test). Microscopic findings of cultured fungus showed hyphae with match-box type microconidia. Preferred anatomical sites were scalp (35.2%), face (32.4%), upper extremities (16.2%), and neck (14.3%). The rate of sex was 89 cases in male and 16 ones in female. The mean age was 16.1+/-4.6, ranged from 3 to 44 years. There is no difference between athletes and non-athletes. Preferred seasons were winter (44.8%) and spring (33.3%). The occurrence of the cases in athletes, which reached the peak in 1997, has been maintained since 1995, while the number of the cases in non-athletes has minimally increased until 2003. Throughout this study it proves that the occurrence of the infection has been disseminating with athletes of a hand-to-hand fight through a lot of physical contact in the center because of frequent athletic meetings since T. tonsurans was introduced in Korea in 1995. Moreover, there is a increasing tendency toward T. tonsurans infection in non-athletes. Therefore, athletic and medical associations should make continual observations of T. tonsurans infection and take close consideration into systematic management and strategy against the infection in order to suppress probable prevalence of the contagion in our society.
Arthrodermataceae ; Athletes ; Europe ; Female ; Fungi ; Glucose ; Humans ; Hyphae ; Inflammation ; Korea ; Male ; Martial Arts ; Neck ; Outpatients ; Prevalence ; Retrospective Studies ; Scalp ; Seasons ; Skin ; Solanum tuberosum ; Sports ; Tinea ; Trichophyton* ; United States ; Upper Extremity

Chromoblastomycosis is a rare disease in Korea and a total of 7 cases have been reported until now. The causative agents were Fonsecaea pedrosi in 5 cases and Phialophora verrucosa in 1 case. Rhinocladiella (R.) aquaspersa is a very rare etiologic agent and only a few cases of chromoblastomycosis due to this fungus have been reported in the Central and South Americas. We report a case of chromoblastomycosis caused by R. aquaspersa in a 52-year-old woman. The lesion was an erythematous, verrucous plaque on the abdomen, 2x1.3 cm in size, and had developed for 6 months before presentation without a traumatic history. She was successfully treated with itraconazole 200 mg/day for 4 months together with surgical excision without recurrence.
Abdomen ; Chromoblastomycosis* ; Female ; Fungi ; Humans ; Itraconazole ; Korea ; Middle Aged ; Phialophora ; Rare Diseases ; Recurrence ; South America