ABSTRACT
BACKGROUND: Recently, identification of fungi have been supplemented by molecular tools, such as ribosomal internal transcribed spacer (ITS) sequence analysis. According to these tools, morphological Exophiala species was newly introduced or redefined. OBJECTIVE: This study was designed to investigate the phylogenetics based on ribosomal ITS sequence analysis from clinical Exophiala species isolated in Korea. METHODS: The strains of Exophiala species were 4 clinical isolates of phaeohyphomycosis agents kept in the department of dermatology, Dongguk University Medical Center(DUMC), Gyeongju, Korea. The DNAs of total 5 strains of Exophiala species were extracted by bead-beating method. Polymerase chain reaction of ITS region using the primer pairs ITS1-ITS4, was done and phylogenetic tree contributed from sequences of ITS region from 5 Korean isolates including E. dermatitidis CBS 109154 and comparative related strains deposited in GenBank. RESULTS: The strains of Exophiala species were 3 strains of E. dermatitidis, 1 strain of E. jeanselmei and 1 strain of Exophiala new species. Among the 3 subtypes (type A, B, C) of E. jeanselmei, E. jeanselmei DUMC 9901 belonged to type B. Of the 2 main types of E. dermatitidis (type A, B) and 3 subtypes of E. dermatitidis type A (A0, A1 and A2), two strains (E. dermatitidis CBS 709.95, E. dermatitidis CBS 109154) belonged to A0 subtypes, 1 strain (E. dermatitidis DUMC 9902) A1 subtype, respectively. CONCLUSION: Phylogenetic analysis of ITS region sequence provided useful information not only for new species identification but for the subtyping and origin of Exophiala species.
Subject(s)
Dermatology , DNA , Exophiala , Fungi , Korea , Phaeohyphomycosis , Phylogeny , Polymerase Chain Reaction , Sequence Analysis , Sprains and StrainsABSTRACT
BACKGROUND: Although tinea pedis is one of the most prevalent diseases caused by dermatophytes, there have been few studies about distribution of dermatophytes on infected soles for this disease in Korea. OBJECTIVE: The purpose of the study was to investigate the distribution of dermatophytes on infected sole using the new direct culture method (Foot-press method). METHODS: The infected soles of 39 patients were directly pressed onto Sabouraud's dextrose agar with cycloheximide prepared in a large culture dish for a few seconds. The culture media were then incubated at 25degrees C for 1-4 weeks. RESULTS AND CONDLUSION: 1. Dermatophyte colonies were isolated from twenty-eight patients (71.8%). 2. Twenty-four of the isolated dermatophytes were Trichophyton (T.) rubrum (85.7%), and the rest were T. mentagraphytes (14.3%). 3. The number of isolated colonies from each patient range from 1 to 102 (Mean+/-SD, 12.8+/-20.7). Three isolated colonies were most common. 4. The isolation frequencies were higher in the patients of keratotic type and in those with tinea unguium (p<0.05). 5. Positive rate was highest in patients with widely-spread lesion (p<0.05).
Subject(s)
Humans , Agar , Arthrodermataceae , Culture Media , Cycloheximide , Glucose , Korea , Onychomycosis , Tinea Pedis , Tinea , TrichophytonABSTRACT
Nodular hidradenoma is a relatively infrequent benign tumor that shows differentiation from or toward the structure of the eccrine sweat gland. We report a case of nodular hidradenoma with apocrine differentiation in a 74-year old female who had an asymptomatic, 3.5x2.7x1.0cm-sized, smooth-surfaced, round, erythematous to bluish tumor mass with cystic grape-like nature on the right thigh for 3 years. Histological findings showed a well-circumscribed tumor composed of solid portions with fusiform basophilic cells and clear round cells, cystic spaces, tubular lumina, squamoid feature and decapitation secretion.
Subject(s)
Aged , Female , Humans , Acrospiroma , Basophils , Decapitation , Sweat Glands , ThighABSTRACT
Acquired digital fibrokeratoma is a relatively unusual benign fibrous tumor that is usually found on the distal extremities. It is characterized by a solitary, flesh-colored, firm and hyperkeratotic projection with a surrounding collarette of raised skin at the base. We report a case of acquired digital fibrokeratoma resembling cutaneous horn in a 31-year-old male who showed a 0.5x0.5x2 cm, firm, hyperkeratotic protruded mass with secondary changes including crust and bleeding on the left 4th finger.
Subject(s)
Adult , Animals , Humans , Male , Extremities , Fingers , Hemorrhage , Horns , SkinABSTRACT
Dermatophytoses are often observed coexisting fungal infections. Trichophyton (T.) rubrum syndrome is defined as the following obligatory criteria. (A) Skin lesions at the following four sites: (1) feet; (2) hands; (3) nails; and (4) at least one lesion in another location than (1) (2) or (3), except for groins. (B) Positive microscopic findings of KOH preparations of skin scrapings in all four locations. (C) Identification of T. rubrum by culture at three of the four locations at least. Three cases of T. rubrum syndrome is reported in a 50-year-old woman, in a 73-year-old man, and in a 55-year-old man.
Subject(s)
Aged , Female , Humans , Middle Aged , Foot , Groin , Hand , Skin , Tinea , TrichophytonABSTRACT
BACKGROUND: There are three kinds of diseases caused by dematiaceous fungi: chromoblastomycosis, phaeohyphomycosis, and eumycotic mycetoma. The dematiaceous fungi have been identified and classified by morphological, biochemical and physiological tests. Recently molecular analysis has been introduced to the field of medical mycology. OBJECTIVE: We investigated the genetic diversity of dematiaceous fungi using random amplified polymorphic DNA (RAPD). METHODS: The dematiaceous fungal strains studied were eight clinical isolates of chromoblastomycosis and phaeohyphomycosis agents (3 strains of Fonsecaea pedrosoi, 2 strains of Exophiala dermatitidis, 1 strain of Exophiala jeanselmei, 1 strain of Phialophora verrucosa, 1 strain of Rhinocladiella aquaspersa) and 4 standard strains (F. pedrosoi IFM 4889, E. dermatitidis IFM 4828, P. verrucosa IFM 4928, R. aquaspersa IFM 4930). Total twelve strains of dematiaceous fungi were cultured on Sabouraud's dextrose broth and their DNA were extracted by bead-beating method. RESULTS: The optimal condition for PCR was template DNA 0.025 mg and annealing temperature 39 degrees C. The RAPD analysis using OPA 10 primer (5'-GTGATCGCAG-3') of Operon kit showed different patterns among dematiaceous fungi. But one clinical isolate of F. pedrosoi showed intra-specific variability. CONCLUSION: The RAPD analysis is considered a rapid and reliable method for identification and classification of dematiaceous fungi if the procedure is carefully standardized with adequate primer.
Subject(s)
Chromoblastomycosis , Classification , DNA , Exophiala , Fungi , Genetic Variation , Glucose , Mycetoma , Mycology , Operon , Phaeohyphomycosis , Phialophora , Polymerase Chain ReactionABSTRACT
Although dermatophytes are still the main etiologic agents of onychomycosis, some species of nondermatophytic molds and yeasts are also capable of invading the nails. Fusarium (F.) solani is a nondermatophytic mold which is saprophytic fungus in soil. Onychomycosis due to Fusarium species almost always involve the great toenails, particularly in the presence of traumatic or dystrophic abnormalities. We report a case of toenail onychomycosis caused by F. solani in a 42-year-old female. The patient presented with typical distal subungual onychomycosis. Direct microscopic examination of scrapings on the potassium hydroxide preparation revealed fungal elements and repeated cultures on Sabouraud's dextrose agar showed the same whitish to cream-colored, cottony colonies. Multiple, sickle-shaped, multiseptate macroconidia and long, slender monophialides were observed in the slide culture. We confirmed F. solani by gross and light microscopic morphology of the colony. The patient was treated with 250 mg of terbinafine daily for 3 months.
Subject(s)
Adult , Female , Humans , Agar , Arthrodermataceae , Fungi , Fusarium , Glucose , Nails , Onychomycosis , Potassium , Soil , YeastsABSTRACT
Psoriasiform lesion is rare in secondary syphilis. We report a case of psoriasiform syphilid in a 36-year-old man, who showed condyloma lata on the perianal area and multiple erythematous scaly plaques on the face, glans penis, scrotum, and both palms and soles. He had sexual contact with prostitute about 3 months ago. The differential diagnosis included papulosquamous diseases, especially psoriasis but a psoriasiform syphilid was confirmed through skin biopsies and serologic tests. The patient was treated with benzathine penicillin G 2.4 million units intramuscularly weekly for 3 weeks. After the treatment with benzathine penicillin G, the skin lesions disappeared completely.
Subject(s)
Adult , Humans , Male , Biopsy , Diagnosis, Differential , Penicillin G Benzathine , Penis , Psoriasis , Scrotum , Serologic Tests , Sex Workers , Skin , Syphilis , Syphilis, CutaneousABSTRACT
Angioleiomyoma is a benign solitary tumor that arises from muscle layer of the vein walls and mainly develops on the lower extremities of middle-aged women. But it is rarely found on the lip. We report an unusual case of angioleiomyoma in a 27-year-old male who showed an asymptomatic, 0.3 X 0.5 cm sized mass on the upper lip for 3 years. Histopathologically, various sized, numerous vessels and bundles of smooth muscle fibers were observed in the dermis.
Subject(s)
Adult , Female , Humans , Male , Angiomyoma , Dermis , Lip , Lower Extremity , Muscle, Smooth , VeinsABSTRACT
Trichilemmal carcinoma is a rare malignant neoplasm of hair follicle which is derived from or differentiates towards the outer root sheath. Despite the frequent presence of histologically malignant features, it has a relatively benign clinical behavior. We report a case of trichilemmal carcinoma in an 87-year-old woman who showed a solitary slightly tender, 1.5X2cm-sized, verrucous, erythematous nodule with crust on the vertex of scalp. In her past medical history, it had been excised at a private clinic without a histopathological evaluation and recurred 1 year later. Histopathologically, tumor cells showed PAS-positive cytoplasms and cytologic atypia with a few mitotic figures. The patient was treated with a wide surgical excision. She has had no evidence of recurrence or metastasis.
Subject(s)
Aged, 80 and over , Female , Humans , Cytoplasm , Hair Follicle , Neoplasm Metastasis , Recurrence , ScalpABSTRACT
Psoriasis vulgaris, a disorder of partially genetic origin, affects 1-3% of the general population. Vitiligo, generally considered an autoimmune disease, affects 0.5% of the general population. Despite the relatively common occurrence of each disease, the concurrence of each disease in a patient has been considered unusual. It is difficult to discern any particular relationship between vitiligo and psoriasis. Assuming that vitiligo and psoriasis are pathogenetically distinct and are grouped independently of each other. We report a case of psoriasis vulgaris associated with vitiligo in a 19-year-old man. Diagnosis was confirmed by clinical and histopathological findings. He is being treated with narrow band UVB phototherapy.
Subject(s)
Humans , Young Adult , Autoimmune Diseases , Diagnosis , Phototherapy , Psoriasis , VitiligoABSTRACT
Subcutaneous panniculitis-like T-cell lymphoma(SPTL) is a rare cytotoxic T-cell lymphoma of the skin, which preferentially infiltrates subcutaneous tissue. In the World Health Organization(WHO) classification of T-cell and natural killer cell lymphoma it is listed as an example of extranodal lymphoma. We report a case of SPTL in a 31-year-old man, who presented with fever, night sweats, fatigue and three, tender, erythematous, indurated, subcutaneous plaques on the trunk. Typical histologic features of panniculitic infiltration with rimming of fat cells and sparing of the dermis and epidermis were seen. The immunophenotypic studies showed a cytotoxic T-cell phenotype by CD3+, CD8+, TIA-1+, CD20- and CD56-. In situ hybridization for Epstein-Barr virus-encoded RNA was negative.
Subject(s)
Adult , Humans , Adipocytes , Classification , Dermis , Epidermis , Fatigue , Fever , In Situ Hybridization , Killer Cells, Natural , Lymphoma , Lymphoma, T-Cell , Phenotype , RNA , Skin , Subcutaneous Tissue , Sweat , T-Lymphocytes , Global Health , World Health OrganizationABSTRACT
Segmental neurofibromatosis(neurofibromatosis type V) is rare disorder characterized by limitation of cafe-au-lait spots and neurofibroma or only neurofibroma on a given unilateral segment of the body. We report a case of segmental neurofibromatosis that developed in a 58-year-old male. The skin lesion was situated on the right antecubital area and wrist in the distribution of dermatomes C5 and C6. Histopathologic examination showed well-demarcated, non-encapsulated tumor of the dermis was composed of thin wavy collagenous fibers and loosely spaced spindle cells with elongated wavy nuclei. The patient was treated with surgical excision and carbon dioxide laser.
Subject(s)
Humans , Male , Middle Aged , Cafe-au-Lait Spots , Collagen , Dermis , Lasers, Gas , Neurofibroma , Neurofibromatoses , Skin , WristABSTRACT
A few case of deep granulomatous cutaneous infection have been reported in the Korean dermatologic literature, but Trichophyton(T.) mentagrophytes granuloma is rare. We report a case of Trichophytic granuloma caused by T. mentagrophytes in a 10-year-old male, who showed three, mild pruritic, coin to walnut-sized, erythematous plaques with indurations and crusts on the face for 1 month. Fungal culture of the biopsy specimen and scales of the lesion revealed T. mentagrophytes. Histopathologic examination of the skin lesion showed chronic granulomatous inflammation in the dermis and fungal hyphae in the hair shaft. After four weeks of terbinafine administration, lesions were cleared with mild erythematous macules.
Subject(s)
Child , Humans , Male , Biopsy , Dermis , Granuloma , Hair , Hyphae , Inflammation , Numismatics , Skin , Trichophyton , Weights and MeasuresABSTRACT
Protothecosis is an unusual cutaneous soft tissue infection caused by the Prototheca, which is a genus of the unicelluar, achloric algae. We report a case of cutaneous protothecosis in a 66-year-old female, who showed erythematous, purulent patches and plaques with ulcerations on the right forearm for 2 months. Biopsy specimen revealed the characteristic thick-walled morulalike sporangia in the dermis. Prototheca wickerhamii was isolated in the culture and the biochemical study. Electron microscopic examination showed the thick-walled spores containing dark dense bodies and amyloplasts. After two months of oral itraconazole 200mg/day, skin lesions were improved.
Subject(s)
Aged , Female , Humans , Biopsy , Dermis , Forearm , Itraconazole , Plastids , Prototheca , Skin , Soft Tissue Infections , Sporangia , Spores , UlcerABSTRACT
Pityriasis versicolor is a mild chronic superficial fungal infection, usually involving the seborrheic area of the neck, upper arms, and back. In a few instances, however, the eruption has been confined to highly atypical areas, such as one palm, the soles, the face, the scalp, the penis, and the groin. Inverse pityriasis versicolor refer to clinical disease located predominantly in flexural areas. We report three cases of inverse pityriasis versicolor in a 55-year-old man, in a 47-year-old man, in a 27-year-old man. The lesion were manifested by slightly scaly, brownish macules on the groin. Potassium hydroxide (KOH) prepatation showed numerous short hyphae and spores, and Wood's lamp examination showed yellowish brown fluorescence of involved skins. Fungal culture on Leeming and Notman's media grew out the typical colonies of M. globosa and M. sympodialis after 2 weeks at 34 degrees C. The patients were treated with 200 mg of itraconazole daily for 1 week and topical antifungals.
Subject(s)
Adult , Humans , Male , Middle Aged , Arm , Fluorescence , Groin , Hyphae , Itraconazole , Neck , Penis , Pityriasis , Potassium , Scalp , Skin , Spores , Tinea VersicolorABSTRACT
Pityriasis versicolor is a mild chronic superficial fungal infection, usually involving the seborrheic area of the neck, upper arms, and back. In a few instances, however, the eruption has been confined to highly atypical areas, such as one palm, the soles, the face, the scalp, the penis, and the groin. Inverse pityriasis versicolor refer to clinical disease located predominantly in flexural areas. We report three cases of inverse pityriasis versicolor in a 55-year-old man, in a 47-year-old man, in a 27-year-old man. The lesion were manifested by slightly scaly, brownish macules on the groin. Potassium hydroxide (KOH) prepatation showed numerous short hyphae and spores, and Wood's lamp examination showed yellowish brown fluorescence of involved skins. Fungal culture on Leeming and Notman's media grew out the typical colonies of M. globosa and M. sympodialis after 2 weeks at 34 degrees C. The patients were treated with 200 mg of itraconazole daily for 1 week and topical antifungals.
Subject(s)
Adult , Humans , Male , Middle Aged , Arm , Fluorescence , Groin , Hyphae , Itraconazole , Neck , Penis , Pityriasis , Potassium , Scalp , Skin , Spores , Tinea VersicolorABSTRACT
Isotopic response is the occurrence of a new skin disorder at the site of another, unrelated, and already healed skin disease. Various diseases have been reported in terms of isotopic response associated with herpes zoster, but the development of comedones is uncommon. We report a case of comedones that had developed on the site previously affected by herpes zoster in a 59-year-old male, which is thought to be an isotopic response. Eight months ago, he visited with herpes zoster lesions on the left upper eyelid, forehead and scalp(dermatome cranial nerve V1). He had grouped and discrete, slightly elevated, skin colored papules with dark, firm hyperkeratotic plug on the healed site of herpes zoster.