No abstract available.
Dermatitis, Allergic Contact ; Lacquer

BACKGROUND: Onychomycosis is one of the most prevalent fungal diseases in the general population. However, treatment is of limited effectiveness and must be administered for long periods of time. Systemic antifungal agents are associated with adverse effects. OBJECTIVE: We evaluated the clinical efficacy and safety of a 1,064-nm neodymium-doped yttrium aluminium garnet (Nd:YAG) laser with amorolfine nail lacquer to treat onychomycosis. METHODS: The 128 patients were randomly divided to 2 groups: 64 in the experimental group were treated with 1,064-nm Nd:YAG laser therapy and amorolfine nail lacquer; the other 64 were in a control group treated with topical amorolfine lacquer monotherapy. The laser treatment was 4 sessions at 4-week intervals and amorolfine lacquer was applied once a week for 16 weeks. Efficacy was assessed as response rate from standardized photographs with ImagePro®Plus (Media Cybernetics, Inc., USA) analysis, microscopic examination, and subjective evaluation. RESULTS: At 16 weeks, the experimental group showed a significantly higher cumulative cure rate than the control group (71.88% vs. 20.31%, p<0.0001). Clinical therapeutic effects were linked to patient satisfaction. The percent of “very satisfied” or “satisfied” responses was higher in the test group than the control group (81.25% vs. 23.44%). The treatment regimen was well tolerated, with transient discomfort observed in the test group. CONCLUSION: The 1,064-nm Nd:YAG laser with amorolfine nail lacquer was effective and safe for treating onychomycosis. This therapy should be considered an alternative treatment, especially for patients with contraindications to systemic antifungal agents.
Antifungal Agents ; Cybernetics ; Humans ; Lacquer* ; Laser Therapy ; Onychomycosis* ; Patient Satisfaction ; Therapeutic Uses ; Treatment Outcome ; Yttrium*

Onychomycosis is caused by dermatophytes usually, but some species of nondermatophytic molds and yeasts are also associated with invasion of nails. Aspergillus(A.) terreus is a nondermatophytic mold which is opportunistic filamentous fungus in all environments. We report a case of onychomycosis caused by A. terreus in a 60-year-old male. The patient showed brownish yellow discoloration with hyperkeratotic change on the distal and lateral portion of both toenails. Direct microscopic examination of scraping on the potassium hydroxide preparation revealed septate hyphae and repeated cultures on Sabouraud's dextrose agar showed the velvety, cinnamon brown colonies. Biseriate and compactly columnar phialides that cover upper vesicle with conidial structure were shown in the slide culture. The DNA sequence of internal transcribed spacer (ITS) region of clinical sample was 99% match to that of A. terreus strain ATCC 20542 (GenBank accession number GU256759.1). We confirmed A. terreus by KOH mount, colony, light microscopic morphology and DNA sequence analysis. The patient was treated with 200 mg oral itraconazole daily and topical 5% amorolfine nail lacquer for 3 months.
Agar ; Arthrodermataceae ; Aspergillus* ; Base Sequence ; Cinnamomum zeylanicum ; Fungi ; Glucose ; Humans ; Hyphae ; Itraconazole ; Lacquer ; Male ; Middle Aged ; Nails* ; Onychomycosis* ; Potassium ; Sequence Analysis, DNA ; Yeasts

No abstract available.
Acute Generalized Exanthematous Pustulosis* ; Chickens* ; Eating* ; Hemodynamics* ; Lacquer*

Onychomycosis is caused by dermatophytes usually, but some species of nondermatophytic molds and yeasts are also associated with invasion of nails. Aspergillus sydowii is a nondermatophytic mold which is opportunistic filamentous fungus in all environments. We report a case of onychomycosis caused by A. sydowii in a 65-year-old male. The patient showed yellowish discoloration with hyperkeratotic change on the distal and lateral portion of both great toenails. Direct microscopic examination of scraping on the potassium hydroxide preparation revealed dichotomous septate hyphae and repeated cultures on Sabouraud dextrose agar showed the same blue green velvety colonies. Biseriate phialides that cover entire vesicle with conidial structure resembling Penicillium were shown in the slide culture. The DNA sequence of internal transcribed spacer (ITS) region of clinical sample was 99% match to that of A. sydowii strain XWSFJJ1 (GenBank accession number FJ461692). We confirmed A. sydowii by KOH mount, colony, light microscopic morphology and DNA sequence analysis. The patient was treated with 250 mg oral terbinafine daily and topical 5% amorolfine nail lacquer for 3 months.
Agar ; Aged ; Arthrodermataceae ; Aspergillus* ; Base Sequence ; Fungi ; Glucose ; Humans ; Hyphae ; Lacquer ; Male ; Nails* ; Onychomycosis* ; Penicillium ; Potassium ; Sequence Analysis, DNA ; Yeasts

Onychomycosis is usually caused by dermatophytes, but some nondermatophytic molds and yeasts are also associated with invasion of nails. The genus Chaetomium is a dematiaceous nondermatophytic mold found in soil and plant debris as a saprophytic fungus. We report the first Korean case of onychomycosis caused by Chaetomium globosum in a 35-year-old male. The patient showed brownish-yellow discoloration and subungual hyperkeratosis on the right toenails (1st and 5th) and left toenails (1st and 4th). Direct microscopic examination of scraping on the potassium hydroxide preparation revealed septate hyphae and repeated cultures on Sabouraud's dextrose agar (SDA) without cycloheximide slants showed the same fast-growing colonies, which were initially velvety white then turned to dark gray to brown. However, there was no growth of colony on SDA with cycloheximide slants. Brown-colored septated hyphae, perithecia and ascospores were shown in the slide culture. The DNA sequence of internal transcribed spacer region of the clinical sample was a 100% match to that of C. globosum strain ATCC 6205 (GenBank accession number EF524036.1). We confirmed C. globosum by KOH mount, colony, and light microscopic morphology and DNA sequence analysis. The patient was treated with 250 mg oral terbinafine daily and topical amorolfine 5% nail lacquer for 3 months.
Agar ; Arthrodermataceae ; Base Sequence ; Chaetomium ; Cycloheximide ; Fungi ; Glucose ; Humans ; Hydroxides ; Hyphae ; Lacquer ; Light ; Male ; Morpholines ; Nails ; Naphthalenes ; Onychomycosis ; Plants ; Potassium ; Potassium Compounds ; Sequence Analysis, DNA ; Soil ; Sprains and Strains ; Yeasts

BACKGROUND: Urushiol is a widely known potent allergen that causes severe contact dermatitis through the epidermis or blood vessels. The role of antigen presenting cells (APC) in allergic contact dermatitis (ACD) is well known, but the role of APC in systemic contact dermatitis (SCD) is not yet fully evaluated. OBJECTIVE: The aim of this study is to observe the changes of APC in thenormal and SCD skin and to discuss their possible roles in the disease process. METHODS: Immunohistochemical differences of the Langerhans cells (LC) and dermal dendritic cells (DDC) were investigated in cases of the normal and SCD skin (Ed note: keep uniformity as above). Immunohistochemical staining with anti-CD1a, S-100 protein, HLA-DR, and factor XIIIa antibodies were performed. The number of CD1a, S-100 protein, and HLA-DR positive cells per mm2 of the epidermis was counted. The number of HLA-DR and Factor XIIIa-positive DDC per mm2 was also evaluated. RESULTS: The LC positive for CD1a and S-100 in the epidermis were slightly higher in SCD, but their difference was not statistically significant. HLA-DR and Factor XIIIa-positive DDC in the dermis weresignificantly increased in the skin of SCD than normal. HLA-DR positive LC in the epidermis was also increased. CONCLUSION: Our results suggest that DDC plays a more important role than that of epidermal LC in urushiol-induced SCD. Increased HLA-DR-positive LC in the epidermis suggests that antigen delivery through the blood also affects the epidermal Langerhans cell beside the dermal dendritic cells.
Antibodies ; Antigen-Presenting Cells ; Blood Vessels ; Catechols ; Dermatitis, Allergic Contact ; Dermatitis, Contact ; Dermis ; Epidermis ; Factor XIIIa ; HLA-DR Antigens ; Lacquer ; Langerhans Cells ; Rhus ; S100 Proteins ; Skin

Onychomycosis is usually caused by dermatophytes, but some species of nondermatophytic molds and yeasts are also associated with nail invasion. Aspergillus niger is a nondermatophytic mold which exists as an opportunistic filamentous fungus in all environments. Here, we report a case of onychomycosis caused by A. niger in a 66-year-old female. The patient presented with a black discoloration and a milky white base and onycholysis on the proximal portion of the right thumb nail. Direct microscopic examination of scrapings after potassium hydroxide (KOH) preparation revealed dichotomous septate hyphae. Repeated cultures on Sabouraud's dextrose agar (SDA) without cycloheximide produced the same black velvety colonies. No colony growth occurred on SDA with cycloheximide slants. Biseriate phialides covering the entire vesicle with radiate conidial heads were observed on the slide culture. The DNA sequence of the internal transcribed spacer region of the clinical sample was a 100% match to that of A. niger strain ATCC 16888 (GenBank accession number AY373852). A. niger was confirmed by KOH mount, colony identification, light microscopic morphology, and DNA sequence analysis. The patient was treated orally with 250 mg terbinafine daily and topical amorolfine 5% nail lacquer for 3 months. As a result, the patient was completely cured clinically and mycologically.
Agar ; Aged ; Arthrodermataceae ; Aspergillus ; Aspergillus niger ; Base Sequence ; Cycloheximide ; Female ; Fungi ; Glucose ; Head ; Humans ; Hydroxides ; Hyphae ; Lacquer ; Light ; Morpholines ; Nails ; Naphthalenes ; Niger ; Onycholysis ; Onychomycosis ; Potassium ; Potassium Compounds ; Sequence Analysis, DNA ; Sprains and Strains ; Thumb ; Yeasts

BACKGROUND: Lacquer contains an allergen, which can cause severe contact dermatitis. Systemic dermatitis resulting from the ingestion of lacquer is quite common in Korea, until now. OBJECTIVE: The purpose of this study is to elucidate the clinical features and laboratory findings of systemic contact dermatitis (SCD), due to the ingestion of lacquer in Chungcheongnam-do. METHODS: We retrospectively reviewed the medical records of 33 patients with SCD, after ingestion of lacquer from Soonchunhyang University Hospital in Cheonan, over a 6-month period. RESULTS: In this study, 33.3% of patients ate lacquer, as a health food, and some (15.2%) by encouragement of friends or spouse. The most common way of ingestion was the lacquer-boiled chicken (48.5%), but many also ate lacquer tree sprouts (42.4%). The skin lesions developed as erythematous maculopapular eruptions, erythema multiforme, erythroderma, purpura, wheals and vesicles. On laboratory findings, 13 patients (52%) exhibited leukocytosis and 11 patients had elevated eosinophil counts. CONCLUSION: The general public is becoming more aware of the toxic effects of lacquer ingestion, but still does not fully understand the dangers of lacquer tree sprouts, and this ignorance is frequently causing SCD in Chungcheongnam-do.
Chickens ; Dermatitis ; Dermatitis, Contact ; Dermatitis, Exfoliative ; Eating ; Eosinophils ; Erythema Multiforme ; Friends ; Food, Organic ; Humans ; Korea ; Lacquer ; Leukocytosis ; Medical Records ; Purpura ; Retrospective Studies ; Skin ; Spouses ; Trees

BACKGROUND: Although there have been many studies about onychomycosis, no study about Koreans in onychomycosis has been reported in Korea. OBJECTIVE: The purpose of this study was to investigate the onychomycosis in Koreans. METHODS: From April, 2009, to March, 2010, 1,893 patients with onychomycosis who visited the department of dermatology at 10 university hospitals were evaluated. RESULTS: Of 1,893 patients with onychomycosis, 93.8% were toenail onychomycosis, 2.2% fingernail onychomycosis, and 4.0% onychomycosis in both toenails and fingernails. Among the age groups, the incidence rate was highest over the sixties (35.6%). The ratio of male to female patients was 1.3:1. Distal and lateral subungual onychomycosis (80.3%) was the most common clinical type of onychomycosis. Combination therapy of oral terbinafine or itraconazole and topical amorolfine nail lacquer was most common in the treatment of onychomycosis. The most common reasons for combination therapy in onychomycosis were higher cure rate due to synergistic activity (40.2%), followed by shortened treatment duration (12.8%), patient compliance (12.3%), and prevention of recurrence and reinfection (1.7%). CONCLUSION: Because of the increase in onychomycosis, we suggest the need of standard treatment guidelines for Korean patients with onychomycosis.
Asian Continental Ancestry Group ; Dermatology ; Female ; Hospitals, University ; Humans ; Incidence ; Itraconazole ; Lacquer ; Male ; Morpholines ; Nails ; Naphthalenes ; Onychomycosis ; Patient Compliance ; Recurrence