A Case of Bilateral Tinea Manus and the Frequency of the Superficial Fungal Hand Infection (1997-2016) / 대한의진균학회지

Dermatophytosis of the palm of the hands (tinea manus) tends to involve one hand. We encountered a case of bilateral tinea manus in a patient with type 1 diabetes mellitus and bilateral tinea pedis. A 57-year-old man presented for evaluation of hyperkeratotic lesions on both his palms and soles. Skin examination revealed hyperkeratotic scaly lesions on the palmar surfaces of his hands and plantar surfaces of his feet. Yellow discoloration and thickening were observed on both his nails. Fasting venous plasma glucose concentration and hemoglobin A1c levels were 332 mg/dL and 7.5%, respectively. Fungus cultures revealed white colonies with brown color on the reverse side in a 14-day incubation period. Trichophyton rubrum infection was identified using polymerase chain reaction with amplified internal transcribed spacer regions. He was treated with oral fluconazole (150 mg/week) and topical flutrimazole spray. In addition, we examined the frequency of 77 superficial fungal hand infections (age, sex, seasonal distributions and coexisting fungal infections) among patients who visited the dermatologic clinic of Chonbuk University Hospital between January 1997 and December 2016.

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.

Tinea Manus Caused by Trichophyton mentagrophytes var. erinacei Transferred from a Hedgehog / 대한피부과학회지

The hedgehog has recently become a fashionable pet in South Korea, especially among the younger persons. However, hedgehogs have been rarely reported to carry fungus that can cause human dermatomycosis. We report such a case. A 12-year-old boy was bitten by his hedgehog one week prior to presentation; he developed two clearly defined erythematous plaques with some pustules on the fingers. Periodic acid-Schiff stain of the biopsy specimen showed long, septated fungal hyphae in the keratin layer. KOH examination and fungus culture showed Trichophyton(T.) mentagrophytes. The subtype was identified as T. mentagrophytes var. erinacei by sequence analysis of the internal transcribed spacer regions of theribosomal DNA. The patient was treated with oral itraconazole (3.3 mg/kg, twice a day for 4 weeks) and topical ketoconazole cream with potassium permanganate wet dressings twice a day, resulting in complete resolution of the skin lesions.

The Efficacy and Safety of Short-term Therapy with Itraconazole Melt-Extrusion Tablet in The Hyperkeratotic Type of Tinea Pedis and/or Tinea Manus / 대한의진균학회지

BACKGROUND: The many antifungal agents have been used in fungal infections. In usual trial agents, itraconazole still remains difficult to absorption in gastrointestinal tract. OBJECTIVE: The purpose of this study is to evaluate the clinical efficacy and adverse reactions of short-term itraconazole melt-extrusion tablet increased in hyperkeratotic type of tinea pedis and/or tinea mauns. METHODS: From November 1998 to February 1999, a total of 60 patients with palmoplantar type of tinea pedis and/or tinea manus at Department of Dermatology of 5 general hospital, were enrolled in a subject group for the study. Itraconazole melt-extrusion tablet was administered, 200mg twice daily, in one week. Clinical symptoms and signs with mycological findings were assessed. RESULTS: Fifty-six patients (male 33, female 23; mean age 36.1+/-10.7; mean duration 6.5+/-4.8) completed the follow-ups. Direct KOH smear examination was positive in all them. Decrease in initial percentages of patients showing symptoms at the last follow-up 2 months after starting therapy: for scale, from 100% to 85.4%; for ertyema, from 91.1% to 10.7%; for hyperkeratosis from 100% to 32.3%; for pruritus, from 82.1% to 10.7%. Mycologic cure rate was 92.9% at the last follow-up. Overall clinical responses evaluated at the last follow-up were 'cured' in 6 pathients(10.7%), 'markedly improved' in 38 patiendts(67.9%), making a clinical response rate of 78.6%. During therapy, transient epigastria pain and indigeastion developed in 5 patients(8.9%). CONCLUSION: With these results, itraconazole melt-extrusion table is considered an effective and safe treatment modality for hyperkeratotic type of tinea pedis and/or tinea manus.

Efficacy of Itraconazole Melt-Extrusion Tablet One-week Therapy in Treatment of Hyperkeratotic Type of Tinea Pedis and/or Tinea Manus / 대한피부과학회지

BACKGROUND: Since the bioavailability of itraconazole capsule is influenced by patients gastric acidity, it results in treatment failure due to its low dissolution and subsequent low absorption when administered in fasting. Itraconazole Melt-Extrusion tablet has been lately developed in order to improve its dissolution profile. It is the first clinical study to evaluate the efficacy and safety of itraconazole Melt-Extrusion tablet in Korea. OBJECTIVE: This study was conducted to evaluate the efficacy and safety of itraconazole melt-extrusion tablet 400mg daily for 1 week(pulse therapy) for hyperkeratotic type of tinea pedis and manus. METHODS: A clinical and mycological investigation was made of 812 outpatients with hyperkeratotic type of tinea pedis and/or tinea manus who had visited at 52 general hospitals under the lead of the Korean Dermatological Association from June to December, 1998. Patients confirmed by clinically and microscopically as hyperkeratotic type of tinea pedis and/or tinea manus were administered 2 tablets twice a day for one week and followed up for 8 weeks from the start of the medication. RESULTS: The results were summarized as follows; 1. Clinical symptoms of hyperkeratotic type of tinea pedis and/or tinea mauns were significantly improved at the end of study, week 8(p<0.001). 2. Clinical response rate, defined as more than 50% decrease of the sum of the clinical symptom scores, was 79.3%(512/646). 3. Mycological cure rate, dafined as both culture and KOH negative at week 8, was 78.2%(244 /312). 4. 40(5.5%) patients, of the 727 patients evaluable for drug safety evaluation, were reported to have adverse event. CONCLUSION: Itraconazole Melt-Extrusion tablet 400mg/day for 1 week (pulse therapy) is effective and safe in the treatment of hyperkeratotic type of tinea pedis and/or tinea manus.

Tinea pedis and tinea manus in children / 대한피부과학회지

BACKGROUND: Because of concern about the infrequent occurre icc of tinea pedis tinea manus, we studied the incidence of them. OBJECTIVE: The purpose of the study was to investigate clinical and mycological features of tinea pedis tinea manus. MEHTODS: We reviewed outpatients with tinea pedis tinea minus at the Catholic Skin Disease Clinic from 1976 to 1991. RESULTS: The incidence was 0.08% out of 1,106,246 outpatients in tinea pedis, 0.02% in tinea manus. Interdigital lesions were the most common in tinea pedis. The ratio of male to female patients was 1.46: 1 in tinea pedis, 1.34:1 in tinea manus. The seasonaI pevalance was highest in summer. The species isolated were, in order of decreasing frequency, Trihohyton(T.) rubrum(89.9%), T. mentagrophytes(8.5%), Microgorum(M.) canis (1.6%) in tinea pedis, T. rubrum(77.8%), T. mentagrophytes(18.2%), M. Canis(2.0%), Epidermophyton(E.) floccosam(2.0% in tinea manus. CONCLUSION: We find that, the incidence of tinea pedis has been inc easing in recent years.