Mycological and Molecular Analysis of Soil Keratinophilic Fungi Isolated in Summer Beaches of the Korean South Coast / 대한피부과학회지

BACKGROUND: Some species of soil keratinophilic fungi (KPF) are known to be pathogens that may lead to cutaneous infection. People exposed to these species through direct contact with soil on beaches can contract KPF infection. However, there is little literature regarding pathogenic KPF isolated from beaches during summer time. OBJECTIVE: This study aims to evaluate the distribution of soil KPF isolated from beaches in Korea during summer. METHODS: One hundred eighty soil samples from six beaches in the southern coastline of Korea under three different climatic conditions were collected. The KPF species were isolated using the hair-baiting technique. Then, molecular identification was performed by sequencing the ribosomal RNA (rRNA) internal transcribed spacer (ITS) region to investigate the exact species of the isolated fungi. RESULTS: Among the one hundred eighty soil samples, twenty-nine strains (16.1%) of KPF were recovered. The isolation rate of KPF among the beaches varied from 0 to 34.5%. KPF was most frequently isolated in shaded dry areas (30%), followed by sunny dry areas (18.3%), and sunny wet areas (0%). Molecular identification of the fungi using rRNA ITS analysis helped in their classification. Microsporum gypseum/Arthroderma incurvatum (69.0%), Microsporum gypseum/Arthroderma gypseum (3.4%), Trichophyton ajelloi/Arthroderma uncinatum (13.8%), Microsporum cookei/Arthroderma cajetani (10.3%), and Chrysosporium indicum/Aphanoascus terreus (3.4%) were identified. Single nucleotide polymorphism (SNP) was observed at position 180 of the rRNA ITS2 in the 20 strains of Microsporum gypseum/Arthroderma incurvatum, and the species was divided into Types 1 (14 strains) and 2 (6 strains) depending on the base present at the SNP position. The geographic distribution of these two types differed. CONCLUSION: Our results show that the beach is a possible source of keratinophilic fungal infection in humans. People should be aware of pathogenic fungi on the soil of beaches during summer and take measures to prevent possible superficial fungal infections.

Radial Arteriovenous Fistula after Coronary Angiography / 대한내과학회지

A 67-year-old man underwent coronary angiography using a transradial approach. Three months after coronary angiography, the patient complained of a thrill detected in his right wrist. Localized compression was performed in the assumption of arteriovenous fistula formation. Since thrill was still detected after localized compression, surgical revision of an arteriovenous fistula was performed. Six days later, radial bruit was still reported. It was decided to perform upper extremity angiography. Upper extremity angiography revealed the remaining arteriovenous fistula from radial artery to cephalic vein, and surgical revision was performed again. This appears to be a very unusual complication related to the transradial approach for coronary angiography.

Pazopanib-induced Hair Depigmentation, Ulcerative Patch in a Patient with Metastatic Renal Cell Carcinoma / 대한피부과학회지

No abstract available.

Acquired Reactive Perforating Collagenosis after Coronary Artery Bypass Graft Surgery / 대한피부과학회지

Perforating disorders are a group of skin disorders that present the characteristic clinical finding of transepidermal elimination. Acquired reactive perforating collagenosis is an uncommon condition characterized by umbilicated hyperkeratotic papules, and in almost all cases, it coexists with other disease conditions, such as diabetes mellitus, renal failure, and malignancies. The pathologic mechanism of this disease remains largely unknown. Here, we describe the case of a 42-year-old man who developed acquired reactive perforating collagenosis after coronary artery bypass graft surgery.

A Case of Phaeohyphomycosis from Exophiala Species Mimicking Facial Cutaneous Tumor / 대한의진균학회지

Phaeohyphomycosis is an infection of humans and other animals caused by a number of phaeoid fungi. It is characterized by the development of dark-colored hyphae and other types of fungal elements in invaded tissues. Phaeohyphomycosis caused by Exophiala species is an unusual infection, but it has been reported with increasing frequency as laboratory methods for diagnosis have improved. A 68-year-old woman presented with yellowish round crusted plaque which is similar to actinic keratosis or keratoacanthoma on her right cheek. Histopathologic examination showed mononuclear cell infiltrate and dark-brown hyphae. The nucleotide sequence of internal transcribed spacer-2 was identical to that of Exophiala species. We report a case of phaeohyphomycosis mimicking skin cancer.

A Case Report of Transfusion-Related Acute Lung Injury Induced in the Patient with HLA Antibody after Fresh Frozen Plasma Transfusion / 대한수혈학회지

Development of transfusion-related acute lung injury (TRALI), a non-cardiogenic pulmonary edema, after blood transfusion, is a rare but potentially leading cause of mortality from blood transfusion. We report on a case of TRALI in a 51-year male with acute calculous cholecystitis and liver cirrhosis. As preoperative treatment, he was given ten units of fresh frozen plasma (FFP) for 3 days before the operation. During the transfusion of the 10th unit of FFP, he experienced a sudden onset of hemoptysis, tachypnea, tachycardia, and cyanosis. Bilateral pulmonary infiltration not observed on the chest X-ray at the visit was newly developed. There was no evidence of volume overload but severe hypoxemia. Blood transfusion was stopped and he recovered fully after 8 days of oxygen therapy through a nasal cannula. Although HLA and HNA antibodies were not detected in the donor's blood, HLA antibodies (A2, B57, B58) were detected in the patient's blood. We reported this meaningful case of TRALI that occurred after transfusion of only fresh frozen plasma which did not contain human leukocyte antibody in a patient with HLA antibody.

The Status and Tendency of Recent Five-year Fungal Cultures as a Diagnostic Measure in a Tertiary Hospital in the Southwestern Daegu Area / 대한의진균학회지

BACKGROUND: Fungal culture is a conventional method for diagnosing fungal infections and is important for determining etiologic agents of the fungal infections. OBJECTIVE: To study the prevalence and validity of fungus culture in various clinical departments. METHODS: A retrospective study of 4373 fungal culture cases at Daegu Catholic University Medical Center from January 2010 to December 2014 was made to investigate the prevalence of fungus culture depending on age, clinical departments, specimens and to evaluate the positive rate along with the distribution factor. RESULTS: The number of fungal culture increased with age. Fungal culture was more commonly performed in departments such as pulmonology (26.7%), ophthalmology (11.7%), dermatology (8.6%), emergency medicine (7.4%), neurology (7.3%). Among the cultured specimens, 43.6% were respiratory specimens, followed by CSF (17.2%), ophthalmic specimens (13.2%), skin (8.7%), and abscess (4.0%). Of the 4,373 specimens cultured, 222 (5.1%) were positive. The most commonly identified fungus was Trichophyton. Fungal culture was routinely performed with bronchoscopy and lumbar puncture. Prophylactic fungal evaluation was carried out for patients who had liver transplantation. CONCLUSION: Our study showed that fungal culture has been excessively conducted, even to a level where some departments take the test on their regular routine basis. The unfettered use of this low-yield diagnostic tool can give a false sense accomplishment and is often cost-ineffective and difficult in altering subsequent diagnostic or therapeutic plans. Clinicians should appropriately assess medical indications of fungal culture counting in the risk of infection, mortality, and cost as well.

A Case of Malignant Melanoma with Zosteriform Skin Metastasis Arising in a Medium-sized Congenital Melanocytic Nevus / 대한피부과학회지

Zosteriform metastasis from malignant melanoma is a rare type of skin metastasis that shows cutaneous lesions including patches, plaques, and nodules along with dermatomes, and thus needs to be distinguished from herpes zoster skin infection. Although some authors have explained the mechanism of zosteriform metastasis, its pathogenesis remains unknown. Herein, we describe an 85-year-old woman with zosteriform metastasis of malignant melanoma arising in a medium-sized congenital melanocytic nevus.

Review of Psychiatric Adolescent Inpatient with Dermatologic Consultations / 정신신체의학

OBJECTIVES: To review the patterns of the dermatologic consultations of psychiatric adolescent inpatient and to explore the relationship between the dermatologic disorders and psychiatric disorders. METHODS: We retrospectively studied the data from 22 cases referred by psychiatric adolescent for a dermatologic consultation over 10 years in Daegu Catholic University Medical Center and compared with the data from 108 cases referred by the other department adolescent patients. RESULTS: The mean age of patients was 15.9. The male to female ratio was 1:1.44. The most common psychiatric and dermatologic disorder was major depressive disorder and acne, respectively. The most frequent reason for consultation was to ask for dermatologic disease or condition(54.5%) followed by to perform cosmetic procedure of patients need(40.9%) and to perform dermatologic test(4.6%). CONCLUSIONS: More than just a cosmetic disfigurement, dermatologic disorders are associated with a variety of psychopathologic problems that can affect the patient. Increased understanding of biopsychosocial approaches and liaison among psychiatrists and dermatologists could be beneficial.

The Clinical and Mycological Study of Tinea Manus and Concomitant Dermatophytosis / 대한의진균학회지

BACKGROUND: Tinea manus is a common superficial dermatophyte infection that is usually coexistent with tinea pedis. Trichophytom rubrum is the most commonly isolated agent in tinea manus. Despite this condition, there have been only a few reports on the clinical and mycological features of tinea manus. OBJECTIVE: This study aims to evaluate the variables related with tinea manus and to determine the correlation with other superficial dermatophyte infection. METHODS: Clinical and mycological features of 54 cases with tinea manus from the department of dermatology in Daegu Catholic University Hospital and the Catholic Skin Clinic from January 2011 to December 2012 were evaluated retrospectively. RESULTS: The male to female ratio was 2:1. The age distribution ranged from 14 to 81 years old. The affected site was the palm in 31 cases (57.4%), the dorsum in 13 cases (24.1%), and both palm and sole in 10 cases (18.5%). Tinea manus was accompanied with other superficial dermatophyte infections, such as tinea pedis, tinea unguium, and tinea corporis in 42 cases (77.8%) and not in 12 cases (22.2%). Fungal culture result was positive in 8 cases of tinea manus only group and in 26 cases of tinea manus with other dermatophyte infection group. The most commonly isolated agent was Trichophyton rubrum in both groups. CONCLUSION: The patients with only tinea manus tend to predilect the dorsum of hand and were relatively more caused by other fungus than Trichophyton ruburum when compared with the patients with other dermatophytosis.