A Clinicomycologic Study of Dermatophytosis of the External Auditory Meatus / 대한피부과학회지

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.

A Case of Block Dot Ringworm Caused by trichophyton tonsurans / 대한피부과학회지

Trichophyton tonsurans is a major causative agent of tinea capitis in the United States, Canada, Mezico and other Latin American countries, but the infection of T.tonsurans has not been reported in Korea. We report a case of tinea capitis caused by T. tonsurans in a 15-year-old student wrestler. He had a 3*3cm sized non-inflammatory alopecia with black dots on the right occipital area of the scalp. The diagnosis was established by a hght microscopic examination of the affected hairs and by mycological studies from cultures. To our knowledge, this is the first case in which T. tonsurans has been isolated in Korea, It is likely that the student acquired the infection through contact with a foreign wrestler during interaational games and practice. We should be concerned about the potential of spread of this infection in our country.

Prevalence of Tinea Pedis of College Students and Their Families in Taegu / 대한피부과학회지

BACKGROUND: Tinea pedis is one of the most comrnon dermatoses in the general population. But its prevalence in the general populat,ion was not yet reported in Korea. OBJECTIVE: Prevalence of tinea pedis and associated tinea unguium were checked in the general population. METHODS: Six hundred fifty eight persons from 179 families of the college students were evaluated. Clinical examinatior. for tinea pedis and onychomycosis and collecting scales from the suspicious lesions of the family members were perforrned by educated college students. Then dermatologists exarnined those specimens mycologically by KOH ~tnount and fungal culture. RESULTS: The results were as follows 1. The prevalence of tinea pedis was 41.2% in the studied 658 persons. 2. Among all 271 patients with tinea pedis, 201 strains of dermatophytes were isolated. They were 143 strains of Trichophyton(T) rubrum, 49 strains of T. mentagrophytes and 9 mixed infections of T. rubrum and T. mentagrophytes. In the co existence of i,inea pedis and tinea unguiurn, isolated species were corresponding. 3. Among 179 families, 143 families (79.9%) had at least one patient with tinea pedis. The isolated species of derrnatophytes in a farnily were one organism, 71.4% and two or more organisms, 28.6% of 77 familiys with more than one patient. CONCLUSION: In our study, the prevalence rate of tinea pedis was 41.2%. That suggests that tinea pedis is a wide spr .ad disease in healthy adult in Korea.