Adult ; Asian Continental Ancestry Group ; Biopsy, Needle ; Disease Progression ; Erythema ; complications ; physiopathology ; Female ; Foot Dermatoses ; complications ; diagnosis ; pathology ; Hand Dermatoses ; complications ; diagnosis ; pathology ; Humans ; Immunohistochemistry ; Pemphigus ; diagnosis ; pathology ; Prognosis ; Pruritus ; complications ; physiopathology ; Rare Diseases ; Singapore ; Syndrome

No abstract available.
Atherosclerosis ; Bacterial Infections ; Foot Ulcer ; Foot ; Tinea Pedis ; Tinea

No abstract available.
Tinea Pedis* ; Tinea* ; Trichosporon*

Kerion celsi is a severe inflammatory type of tinea capitis that presents as a boggy mass studded with broken hairs, oozing purulent material from follicular orifices. This infection is caused most commonly by zoophilic or geophilic pathogens. Trichophyton(T.) rubrum is an anthropophilic dermatophyte that is found all over the world. It has become one of the most important causative agents in tinea unguium and tinea pedis. But, kerion celsi caused by T. rubrum is rare. Kerion celsi is uncommon in adult. We report a case of kerion celsi caused by T. rubrum in a 72-year-old woman. She presented with localized tender erythematous plaques with pustules with oozing purulent material on the frontal scalp. A fungal culture from tissue of the lesions was grown on Sabouraud's dextrose agar and showed typical whitish cottony colonies of T. rubrum. The nucleotide sequence of internal transcribed spacer region for clinical isolate was identical to that of T. rubrum strain UZ1588_14 (GenBank accession number KP326579.1). She was treated with 200 mg of oral itraconazole daily for 3 months. The skin lesions improved 1 month after treatment, and recurrence has not been observed.
Adult ; Agar ; Aged* ; Arthrodermataceae ; Base Sequence ; Female ; Glucose ; Hair ; Humans ; Itraconazole ; Onychomycosis ; Recurrence ; Scalp ; Skin ; Tinea Capitis* ; Tinea Pedis ; Trichophyton*

BACKGROUND: Pediatric onychomycosis has been previously investigated; however, the specific causative agents of onychomycosis in Korean children have not been reported. OBJECTIVE: This study aimed to determine the most common causative agents of onychomycosis in Korean children. METHODS: We reviewed the medical records of 149 pediatric patients (<18 years of age) referred for fungal cultures because of a clinical suspicion of onychomycosis between 2005 and 2014 at our clinic. Patient specimens were cultured on Sabouraud's dextrose agar with and without cycloheximide. RESULTS: Onychomycosis was clinically suspected in 149 children. Of the 44 patients with onychomycosis, confirmed by culture, 72.7% had toenail onychomycosis, 22.7% had fingernail onychomycosis, and 4.5% had toenail and fingernail onychomycosis. The male-to-female patient ratio was 1.93:1. Fourteen (31.8%) children had concomitant tinea pedis, and 12 (27.2%) had family members with tinea pedis or onychomycosis. Distal and lateral subungual onychomycosis were the most common (68%) clinical types. Trichophyton rubrum was the most frequently isolated pathogen (66.7%), followed by Candida albicans (14.8%), Microsporum canis (11.1%), Candida parapsilosis (3.7%), and Candida tropicalis (3.7%). Candida albicans was the most commonly isolated pathogen (50.0%) in fingernail onychomycosis. CONCLUSION: Pediatric onychomycosis is more common than most people think. Thus, we suggest the need for a careful mycological examination of children with suspected onychomycosis.
Agar ; Candida ; Candida albicans ; Candida tropicalis ; Child* ; Clinical Study* ; Cycloheximide ; Glucose ; Humans ; Medical Records ; Microsporum ; Nails ; Onychomycosis* ; Tinea Pedis ; Trichophyton

Trichophyton(T.) rubrum is an anthropophilic dermatophyte that is found all over the world. It has become one of the most important causative agents in tinea pedis and onychomycosis. But tinea capitis caused by T. rubrum is rare. Tinea capitis is uncommon in an adult. We report a case of tinea capitis caused by T. rubrum in an 81-year-old woman. She presented with localized asymptomatic well-demarcated thick scaly erythematous patches on the fronto-vertex scalp for 6 months. She was diagnosed as seborrheic dermatitis in local clinic and was treated with topical steroid. However, the lesion was not improved and spreading. Culture from scalp lesion of patient was grown on Sabouraud's dextrose agar and showed typical whitish cottony colonies of T. rubrum. She was treated with 200 mg of oral itraconazole daily for 8 weeks. The skin lesions improved 8 weeks after treatment, and recurrence has not been observed.
Adult ; Agar ; Aged, 80 and over* ; Arthrodermataceae ; Dermatitis, Seborrheic ; Female ; Glucose ; Humans ; Itraconazole ; Onychomycosis ; Recurrence ; Scalp ; Skin ; Tinea Capitis* ; Tinea Pedis ; Tinea* ; Trichophyton*

Trichophyton rubrum is a common cause of superficial dermatophytosis in humans, such as tinea pedis, tinea unguium, tinea corporis and tinea cruris. T. rubrum usually attaches to keratin of the epidermis and uses it as a source of nutrients. Therefore, isolation of T. rubrum from non-keratinous skin, such as ulcer, is very rare. We describe 4 patients with T. rubrum-infected diabetic foot ulcer.
Diabetic Foot* ; Epidermis ; Humans ; Onychomycosis ; Skin ; Tinea ; Tinea Pedis ; Trichophyton* ; Ulcer*

BACKGROUND: Trichophyton(T.) rubrum is most common fungal pathogen that causes tinea pedis and onychomycosis. It recurrently infects human and usually persists for very long time, provoking public health concern. Due to the limitation in current treatment options, alternative therapies are desirable. We investigated the inhibitory effect of UVC, terbinafine hydrochloride 1% and paeonia natural extracts on T. rubrum in vitro. OBJECTIVE AND METHOD: Total 25 T. rubrum strains were cultured for 10 days on Mycosel agar plate; 5 strains of T. rubrum and 5 copies for each strain. They were divided into 5 groups: control, UVC irradiation, terbinafine spray, paeonia natural extracts spray, UVC and paeonia natural extracts sprays. The cultured media were irradiated for 1 hour daily for 3 weeks in the germicidal lamp emitting 253.7 nm (UVC), power of 2.875 mW/cm2 at 10 cm distance. Terbinafine and paeonia extracts was sprayed twice on the surface to fully cover the colony area. The median diameter of each colony were measured every other day for 3 weeks. The change of colony diameter and the growth rate were analyzed. RESULTS: The UVC had virtually no effect on restraining the growth of T. rubrum, similar with the growth of the control group. However, both the terbinafine spray and paeonia extracts slowed down the growth rate remarkably and showed a similar effect. CONCLUSION: We could only figure out the fungistatic effect, and not the fungicidal effect of paeonia extract and terbinafine hydrochloride in vitro. UVC irradiation setting in this study was totally ineffective. More studies are needed on more variable wavelength and the fluence of UVC irradiation. In addition, further verification on the mechanism and the effect of anti-fungal activity by paeonia extracts are needed.
Agar ; Complementary Therapies ; Humans ; Onychomycosis ; Paeonia* ; Public Health ; Tinea Pedis ; Trichophyton*

BACKGROUND: Cellulitis is an acute infection of the dermal and subcutaneous layers of the skin, which is commonly treated by a dermatologist but there are few reports about clinical data on cellulitis in Korean literature. OBJECTIVE: This study evaluated the clinical characteristics of inpatients diagnosed as cellulitis in the recent 5 years. METHODS: We reviewed the medical records of 77 patients who were diagnosed as cellulitis and hospitalized at the Kangbuk Samsung Hospital from March 2008 to February 2013. RESULTS: The study included data from 77 patients with cellulitis (mean age, 51.7 years; 44 men, 33 women). There was a positive correlation between age and hospitalized days (p<0.05). Cellulitis most frequently occurred in the foot (32.1%). The most common cutaneous symptoms were erythema, tenderness, and swelling (100%), and the most common systemic symptom was fever (23.4%). Tinea pedis was the most common cause of cellulitis (31.2%). Elevation of C-reactive protein (CRP) was observed in 30 patients (40%) and there were positive correlations not only between CRP and hospitalized days (p<0.05) but also between white blood cell (WBC) count and hospitalized days (p<0.05). First-generation cephalosporin was chosen as the primary antibiotic in 33 patients (40.3%) and the mean duration of antibiotic treatment was 12.4 days. There was no significant difference of hospitalized days between first-generation cephalosporin and other antibiotics (p>0.05). Systemic steroid was administered in 21 patients (27.3%), and was not significantly related to hospitalized days (p>0.05). CONCLUSION: The clinical course of cellulitis was inversely correlated to the elevation of patient's age, WBC count, and CRP.
Anti-Bacterial Agents ; C-Reactive Protein ; Cellulitis* ; Erysipelas ; Erythema ; Fever ; Foot ; Humans ; Inpatients* ; Leukocytes ; Male ; Medical Records ; Skin ; Tinea Pedis

INTRODUCTIONCryotherapy with liquid nitrogen is an effective, safe and convenient form of treatment for plantar warts. EMLA® cream (eutectic mixture of lidocaine 2.5% and prilocaine 2.5%) is a topical local anaesthetic agent that has proven to be effective and well tolerated in the relief of pain associated with various minor interventions in numerous clinical settings.

MATERIALS AND METHODSIn a single-centre, double-blind, randomised placebo-controlled study, 64 subjects were randomised into 2 groups. The subjects had a thick layer of EMLA® cream or placebo cream applied to pared plantar wart(s) and onto the surrounding margin of 1 mm to 2 mm under occlusion for 60 minutes prior to receiving cryotherapy. The pain of cryotherapy was evaluated by the subjects using a self-administered Visual Analogue Scale (VAS) immediately after the cryotherapy.

RESULTSThere was no statistical difference between the mean VAS score for EMLA® cream (47.0 ± 21.4 mm) and placebo (48.9 ± 22.0 mm). Those with more than 1 wart had a significantly higher VAS score than those with only 1 wart (59.1 ± 21.8 vs. 44.3 ± 20.4, P <0.05) but this did not affect the therapeutic effect of EMLA® cream prior to cryotherapy.

CONCLUSIONWe conclude that the application of EMLA® cream prior to cryotherapy does not reduce the pain associated with cryotherapy.

Adult ; Analgesia ; Anesthetics, Local ; therapeutic use ; Cryotherapy ; Double-Blind Method ; Female ; Foot Dermatoses ; therapy ; Humans ; Lidocaine ; therapeutic use ; Male ; Middle Aged ; Ointments ; Prilocaine ; therapeutic use ; Warts ; therapy ; Young Adult