Epidemiological, Clinical and Mycological Studies of Trichophytosis Gladiatorum Prevailing among Korean Judoists / 대한의진균학회지

BACKGROUND: Since 1995, a nation-wide outbreak of trichophytosis gladiatorum has been noted among wrestlers and judoists alike in Korea. OBJECTIVE: To investigate the current status of the illness among Korean judoists. METHOD: The epidemiological, clinical and mycological studies were performed on dermatophytosis among athlelets during all-Korea judo tournaments from April, 1999 to May, 2000. RESULTS: A total of 316 cases of trichophytosis gladiatorum were detected throughout the country. The majority of patients (204, 64.6%) were high school students, followed by judoists attending middle school (18.7%), and college and above (16.7%). The scalp was the most favorite site of the skin lesions, followed by upper extremities including hands, face, neck, trunk and legs. The right arm was affected by tinea 1.6 times more frequently than the left one; in the legs the right to left ratio was 0.6. As a whole, the lesions developed in equal frequency on each side of the body. The scalp lesions were noted in 133 patients (42.1%) : erythematous scaly patches were the most frequent, affecting 66.2% of the tinea capitis patients, followed by black dot ringworm (55.6%), alopecia (33.1%), etc. Twenty six (8.2%) of the entire trichophytosis patients had a family history. Mother, brothers, father, sisters, and aunt were said to be affected by the illness in a decreasing order of frequency. Out of 316 patients, 38 (12.0%) were culture negative and 36 (11.4%) showed a contaminant. From the remaining 242 patients (76.6%), Trichophyton tonsurans (mahogany variety) was isolated. Randomly selected 38 strains of T. tonsurans showed positive results for hair perforation and urease test. CONCLUSION: Trichophytosis gladiatorum has recently been rampaging among domestic judoists. A sustained follow-up study seems necessary to monitor the spread of T. tonsurans infection to the general population from the reservoir of judoists.

Chromoblastomycosis Treated with Occlusive Dressing of Amphotericin B Cream / 대한의진균학회지

We report a case of chromoblastomycosis in a 65 year-old woman. She had a 3x4 cm sized, annular, erythematous, plaque with crusts and ulcers on the right lower arm. The lesion had grown slowly for 2 years. In fungal and histopathologic examinations, several muriform cells were found in dermis as well as in scales and crusts on the lesional skin surface. Isolated fungus was identified as Fonsecaea pedrosoi. We treated the patient occlusive dressing of amphotericin B (3%) ointment for 8 weeks and achieved a good response without any evidence of recurrence. We propose that the occlusive dressing therapy of amphotericin B cream is a good modality among the various treatments of small localized chromoblastomycosis.

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.

Three Cases of Kerion Celsi Caused by Trichophyton tonsurans / 대한의진균학회지

We report three cases of kerion celsi caused by Trichophyton tonsurans in 16-year-old students of one high school wrestling team. The first case presented a 10x5cm and several 3~4cm sized, markedly inflammatory, boggy lesions on the scalp for 5 months. Other cases showed several 2~4cm sized, erythematous, follicular pustules and nodules with partial alopecia on the scalp for 2 months. Histopathology and results of mycologic study were consistent with kerion celsi due to Trichophyton tonsurans. All lesions were successfully treated with griseofulvin 500mg daily for 7~15weeks and short term therapy of low dose of prednisolone and cephadroxil.

The Clinical and Epidemiological Studies of Microsporum canis Infections (1983-1992) / 대한의진균학회지

BACKGROUND: Microsporum(M.) canis infection was first discovered in 1957 in Korea, but it did not spread and disappeared after 1960. It was iscovered again in 1975, and rapidly spread all over the country. In the 1980's, M. canis became one of the most important dermatophytes that infected humans. OBJECTIVE: The purpose of this study is to evaluate the clinical and epidemiological characteristics of M. canis infections. METHODS: We observed the clinical and epidemiological status in 2,256 cases of M. canis infections that were mycologically diagnosed at the Catholic Skin Disease Clinic from 1983 to 1992. RESULTS: The rate of M. canis infections compared to total dermatophytoses(25,907 patients) was 8.7%. The annual number of patients with M. canis infection increased gradually from 1983 and was highest frequency in 1986. Then the number of patients with M. canis infection was markedly decreased till 1992. The ratio of male to female patients was 0.85: 1(male:1,039, female:1,217), but the ratio in children (age16) was 0.33: 1. Children were chiefly involved as 82.6% of the patients. There were more patients in winter(35.3%) and followed by fall, summer and spring. M. canis infections were mostly composed of tinea(T.) capitis(64.2%), T.faciale(17.7%) and T. corporis(14.6%). In the seasonal distribution of M. canis infections, T. capitis was the most common in winter(38.8%) and was the lowest in summer(15.4%), but T. corporis was the most common in summer(42%). There was a difference in disease pattern between children and adults in M. canis infections; In children, M. canis infections were T. capitis(73.6%), T. faciale(16.3%),7 corporis(9%), but in adults, those were 7. corporis(41.3%), 7. faciale(24.5%), T. capitis(19.4%) in the order of decreasing frequency. CONCLUSION: We observed a gradual decrease in number of patient with M. canis infection after 1986. We suggest that M. canis infections would decrease more and more in the future in Korea.

A Case of Erythema Elevatum Diutinum Occuring in a Child / 대한피부과학회지

We report a case of erythema elevatum ditinum in a 6-year-old girl. Th symmetrically distributed skin lesions consisted of elevated purplish annular plaques and nodules on the elbows, knees, ankles and buttocks, and some of the lesions showed vesicles, hemorrhagic crusts, and necroses. Biopsy specimens from the knee and ankle revealed typical leukocytoclastic vasculitis. Ve performed a Multites CMI, a test for delayed r.utaneous hypersensitivity, in which the patient showed positive reaction to streptococcal antigen(Lancefield group C). We tried oral prednisolone and dapsone seperately and could see a remarkable response to both drugs.

A Case of Embryonal Rhabdomyosarcoma of the External Female Genitalia / 대한피부과학회지

We report a case of embryonal rhabdomyosarcoma with palpable right inguinal lymph node in a 6-year-old girl which developed rapidly on the right labia minora over a period of 2 montha. Histopathological study showed characteristic findings of spindle shaped rhabdomyoblast with hyperchromatic nuclei and cytoplasmicprocesses. After a preoperative chemotherapy with vincristine, actinomycin D, and cytoxan, the size of the mass was reduced, and lymph nodes were not palpable. And then, simple vulvectomy. postoperhtive cheirnatherapy and radiotherapy were done.

Clinical and Histopathologic Observations on Nevus Sebaceus of Jadasshon / 대한피부과학회지

Clinical observations were made on 63 cases on nevus sebaceus of Jadasshon. 52 of 63 cases were diagnosed on the basis of clinical and histopathologic findings during a period of 19 years from January 1969 to July 1987 at the Department of Dermatology, Kyungpook National University Hospital, with the remaining 11 cases diagnosed at other skin clinics in Taegu. Histopathologic examinations were made on 51 selected cases of the 63. The results were as follows : Clinical observations 1) The percentage of patients with nevus sebaceus of Jadasshon of total new outpatients was 0.12%. Of the 63 cases, males numbered 38 and females, 25, with a sex r atio of 1.5: 1. 2) Patients when first seen were most commonly in the age group of 10~19. 3) The most favorate sites were the scalp(83.3%) and face(13.3%). 4) The average size of the lesions was 2.23cm * 3.24cm with no difference among the age groups. Histopathological observations 1) The apparent proliferation of sebaceous glands was observed in 32 of 51 cases(62.7%). The degree of proliferation markedly increased in the age group of l0~19 and slightly decreased beyond this age group. Apocrine glands were present. in 17(33.3%), with a higher number of glands seen in the age group of 10~19. Immature hair follicles were found in 38(74.5%), with no changes according to aging. 2) The epidermal changes such as acanthosis(86.3%), papillomatosis(70.6%), hyperkeratosis(78.2%) and hypergranulosis(78.2%) predominated in the age group of 10-19, and severe but more gradual changes were noted 20 years of age on. 3) Inflammatory cell infiltration of moderate to marked degree was noticeable in 27(53%). The older the patients were, the more pronounced dermal infiltration was. 4) Six of 51 cases were complicated with basal cell carcinoma(3) and syringocystadenoma papilliferum(4). The tumors, which occurred beyond 30 years of age, showed a marked inflammatory cell infiltration.

A Case of Demodicidosis in Early Childhood / 대한피부과학회지

We herein report a case a demodicidosis, which is extremely rare in early childhood, in a 19 month old boy. He had been admitted to the department of plastic surgery for 20 days because of burn on both legs. During admission, he hadn't had his face washed at all. He was referred to our department due to progressively appearing, multiple, pinhead sized, dry scaling, erythematous papules on the face of 13 days duration. KOH mounts from the scaly papules revealed numerous hair follicule mites. We treated him with topical application of 25% benzoy1 peroxide gel to see complete clearing of the lesions in 32 days. We think that prolonged ret.ention of sebum in the unwashed skin, such as in our case, may predispose to the poliferation of the hair follicule mites.

Two Cases of Non - venereal Sclerosing Lymphantitis of the Penis / 대한피부과학회지

We report two cases of nonvenereal sclerosing lymphangitis of the penis in a 34-year old man and a 28-year-old man. This disorder is an uncommon condition characterized by asymptomatie, firm, cord-like lesion of unknown etiology. Histopathologic findings reveal hypertrophy and sclerosis of lymphatic vessel walls, and some cases show thrombus formation within dilated vessels. Both cases had typical clinical and histopathologic features. In case I, the lesion resolved spontaneously on several occasions for 10 years. Therefore we argue that some individual may be predisposed to develop the condition, perhaps because of anatomical variation.

A Case of cutis Verticis Gyrata due to Cerebriform Intradermal Nevus / 대한피부과학회지

Cutis verticis gyrata is a morphologic term, typically occurring on the scalp, characterized by eleuated, folded convolutions of the scalp, which may be either secondary to local disease in the scalp, or primary(idiopathic) disease. This case report was a 33-year-old woman, teacher. A birth, the patient had a small, round, soft, convoluted mass on the right parietal scalp. The mass slowly enlarged in size with the same rate of body growth. Now, the lesion is 15*13cm in size, well demarcated, oval shaped, soft, convoluted mass with overlying normal skin colored or hyperpigmented macules. Light microscopic findings of the skin kesion showed deeper extension of the nevus cells into the dermis and subcutis, which presented as an intradermal nevus, Electron microscopy showed that the nevus cell had an indented nucleus and numerous mitochondrias and melanosomes in the cytoplasm.