Clinicopathological Observation in Trichotillomania and Pathologs after Hair Plucking in Rabbits / 대한피부과학회지

BACKGROUND: Trichotillomania appears as incomplete alopecia due to patients own repeated manipulations of the hair. But there are few available clinicopathologic data in Korea. OBJECTIVE: The purpose of this study was to evaluate the clinicopathological feature of trichotillomania and the experimental pathologic findings after hair plucking in rabbits. METHOD: Through retrospective study on patients who were diagnosed as trichotillomania from 1988 to 1997 at the Department of Dermatology in Pusan National University Hospital, we observed the clinical and histopathological findings in 20 cases of trichotillomania as well as histopathologic changes of hair follicle and associated structure after hair plucking in rabbits with 4 days interval. RESULTS: 1. The mean age of onset was 15.7 years and female were 12 cases(60%). 2. The school age(between 7 and 18 years) was most common as 15cases(75%) 3. Among initial sites of involvement, parietal region was the most common(10 cases, 55%), followed by frontal(5 cases, 25%), temporal(2 cases, 10%), and occipital(2 cases, 10%) region. 4. Some patients complained pruritus(25%), chronic headache(10%) and had onychophagia (20%), trichophagia(5%) and thumb sucking(5%). 5. Many patients were not typical in history, and 14 cases(70%) denied hair-plucking history. 6. Results of twelve patients with psychiatric consultation revealed obsessive disorder(4 cases, 33%), social phobia(2 cases, 17%) and dysmorphic disorder(1 case, S%). 7. The most common presumptive triggering factor was mental stress related to school work(5 cases, 25%). 8. The characteristic findings of histopathologic examination in 20 cases were empty hair follicles without perifollicular infiltration(100%) and increased catagen hair(90%) with normal anagen hair(85%), trichomalacia(40%). 9. In experimental hair plucking of rabbit, soon after hair plucking, dilated empty root sheaths, perifollicular hemorrhage were observed. These findings are similar in trichotillomania. Catagen evolution, sebaceous proliferation and hyperplasia at 4th day, prominent bulge region at 8th day, growing epithelial sheaths into deep dermis at 12th day, many anagen hair at 20th day were observed. CONCLUSION: Trichotillomania was more frequent in young than adolescent and female than male. Histopathologically, the most characteristic finding was increased catagen hair without perifollicular inflammation. In hair follicle regeneration of rabbit after plucking, all hair follicles changed into catagen and telogen stage simultaneously and new hair growth was observed.

A Case of Multiple Endocrine Neoplasia type 3 With Multiple Mucosal Neuroma / 대한피부과학회지

Multiple endocrine neoplasi~a type 3 is a rare, heritable or sporadic, multiple neoplastic disorder that is charracterized by thyroid medullary careinoma, pheochromocytoma, multiple mucosal neuroma, and marfanoid habitus. The most important disorder of the syndrome is mucosal neuroma that is an early diagnostic sign of multiple endocrine neoplasia type 3. Early diagnosis of MEN type 3 determines prognosis of the disease. We present a case of multiple endocrine neoplasia type 3 of the sporadic pattern in a 27-year-old man who had typical medullary thyroid carcinoma, mucosal neuroma, marfanoid habitus, and megacolon.

A Clinical Study of 381 Patients with Childhood Vitiligo / 대한피부과학회지

BACKGROUND: Vitiligo, the pigmentary disorder of the skin and hair, affects patients of various ages from neonates to old adults. According to the onset age, vitiligo is classified as adult or childhood type. Previous clinical studies on childhood vitiligo are rare in Korea. OBJECTIVE: Our purpose was to evaluate the clinical characteristics of childhood vitiligo. METHOD: A clinical investigation was made of 381 outpatients with childhood vitiligo (between 6months and 15years of onset) who had visited the Department of Dermatology, Pusan National University Hospital from January 1988 till December 1997. Results : The results a summarized as follows 1. The subjects consisted of 206(54.1%) females and 175(45.9%) males. 2. The mean age of onset was 7.7 years(males : 8.0, female 7.5). 3. The mean duration of the disease was 2.6 years(male : 2.5, female : 2.7). 4. Familial history was obtained in 30 cases(7.9%) and the most common precipitating factor was trauma(40.0%). 5. Both vulgaris(43.3%) and segmental type(30.4%) were common clinical types in the classification of Ortone et at. Trigeminal distribution(53.4%) was the most common segmental types in Koga's classification. 6. The most common site of initial involvement was the face and neck(52.2%) 7. The most common degree of depigmented lesion was within 5%(84.5%). 8. The progression of vitiligo was present in 68.2% of patients and the incidence of poliosis was 11.5%. 9. Koebner phenomenon was present in 12 cases(3.1%). 10. The most common associated diseases were acne and halo nevus (18.0%). Conclusion : Childhood vitiligo is relatively unique in the clinical findings such as the clinical type(high incidence of segmental type), precipitating factor(trauma is the main factor), depigmented area(small involvement in the extent of the lesion) and the progression of the disease.

Two Cases of Generalized Granuloma Annulare Controlled by Hydroxychloroquine / 대한피부과학회지

We report the clinical evolution of two male patients with generalized granulama annulare(GGA) who were controlled with hydroxychloroquine. In the first case, a 3-year-old boy was treated with systemic steroid, and in the second case, a 68-year-old man was treated with prednisolone, niacin, and retinoic acid. But, remission and recurrence of the skin lesions were repeated. A good clinieal response was achieved in both cases after administration of hydroxychloroquine without side effects or any signs of recurrence. Hydroxychloroquine may be helpful to treat the GGA that have side effects to the systemic corticosteroid or resistence to other therapeutic modalities.

A Case of Woringer Kolopp Disease Treated with Topical PUVA / 대한피부과학회지

A 26-year-old Korean man had an erythematous scaly plaque on his right thigh for fifteen years. He was diagnosed with chronic eczema and treated with topical steroid, but no clinical improvement was obtained for 15 years. Laboratory studies including complete blood cell count, urinalysis, liver and renal function test, and peripheral blood smear were normal. A biopsy specimen showed hyperkeratosis, acanthosis, and mononuclear cellular infiltration in the epidermis. These cells had a perinuclear halo and showed a Pautrier's microabscess like configuration. In the dermis, there was a band like infiltration of inflammatory cells. Infiltrates of the epidermis were negative for leukocyte common antigen(CD45) and positive for Pan T cell(CD45RO). He was treated with topical PUVA twice a week for twelve weeks. Clinical and pathological improvements were obtained. We propose PUVA may be a useful therapeutic modality to treat Woringer Kolopp disease.

Immunohistochemical Study of T lymphocytes Infiltrated in Mycosis Fungoides: Comparison with Psoriasis and Eczema / 대한피부과학회지

BACKGROUND: Sometimes, the clinical distinction between early-stage mycosis fungoides and benign inflammatory deimatoses such as psoriasis and dermatitis can be difficult, and it is not uncommon for the histological changes to be non-diagnostic in early-stage mycosis fungoides. Aberrant immunophenotypic expression of T cells occurs frequently in mycosis fungoides, but is uncommon in benign dermatosis. OBJECTIVE: We investigated the distribution and relative numbers of T lyinphocytes and epidermal cells labelled with various monoclonal antibodies in mycosis fungoides, psoriatic, and eczematous lesions by the immunoperoxidase technique. METHODS: Lesional skin tissues were obtained from 7 mycosis fungoides(10 tissues), 9 psoriasis, and 9 eczema patients. Immunohistochemical staining was done on the frozen sections using a labelled streptavidin-biotin-peroxidase complex method with primary antibodies against CD3, CD4, CD5, CD7, CD8, Leu-8, and HLA-DR. RESULTS: The infiltrating cells in mycosis fungoides, psoriatic, and eczematous lesions were uniformly stained with anti-CD3 and most of CD3+ T cells were also stained with anti-CD4. CD 7 expression of T cells was decreased predominantly in mycosis fungoides but loss of CD7 expression was not prominent in psoriatic and eczematous lesions. In the epidermis, HLA-DR was stained extensively in keratinocytes of mycosis fungoides, but only focal staining of HLA-DR was seen in psoriatic and eczematous lesions. CONCLUSION: These findings suggest that CD4+, CD7- T cells and HLA-DR expression of keratinocytes participate in the development of mycosis fungoides, and are helpful in differentiating mycosis fungoides from psoriasis and eczema.

A Study on the Role of Bacteria in the Pathogenesis of Confluent and Reticulated Papillomatosis / 대한피부과학회지

BACKGROUND: The pathogenesis of confluent and reticulated papillomatosis(CRP) is still unknown, although many theories have been suggested. It is stressed that abnormal host response to colonization of pityrosporum orbiculare might play a role in the pathogenesis of CRP, but is not completely understood. Frequently, we have observed bacterial colonies in the stratum corneum and, especially, within the hair follicles from biopsy specimens of patients with CRP. In addition, successful treatment for CRP with minocycline, a derivative of tetracyclines, has been reported continuously. OBJECTIVE: The purpose of this study was to document the possible association of bacterial factors in the pathogenesis of CRP and to elucidate the effectiveness of minocycline. METHODS: We performed Brown and Brenn gram staining in 12 biopsy specimens, bacterial cultures, identification of microorganisms and antibiotics sensitivity testing including minocycline. We administered oral minocycline with an initial dose of 100mg per day for 1 to 3 months and a maintenance dose 50mg per day for I to 2 months, then evaluated the response of treatment. RESULTS: 1. On Brown and Brenn staining, the gram positive bacterial colonies that stained dark bluish or nearly black were observed within the infundibulum of hair follicles in 10 out of 12 biopsy specimens(83.3%) and on the keratotic invagination of stratum corneum in 11 out of 12 biopsy specimens(91.7%). 2. Histological features of regions where bacterial colonies were observed showed, hyperkeratosis and keratotic invagination on the stratum corneum in all cases. Hyperkeratosis(66.7%), parakeratosis(16.7%), inflammatory cell infiltration(25.0%), perifollicular fibrosis(33.3%), and abnormal keratin in sebaceous ducts(50.0%) were shown in hair follicles. 3. In anaerobic cultures, no bacteria was grown. In aerobic cultures, staphylococcus species were identified in 6 cases, streptococcus viridans in one case, sternotrophomonas maltophilia in one case. In the susceptibiliity test, minocycline was sensitive in 7 from 8 cases. 4. The therapeutic response to minocycline was observed within one month in all cases, and the time to clear the lesions was 1/2 month in 2 cases, 1 month in 4 cases, 2 months in 5 cases, 3 months in one case, respectively. CONCLUSION: Form these results, we suggest that bacterial factors may play an important role in the pathogenesis of CRP and that the action mechanism of minocycline in the treatment of CRP may be due to antibacterial effects.

A Case of Black Dot Ringworm Caused by Trichophyton violaceum / 대한의진균학회지

Tinea capitis is a dermatophytosis of the scalp and associated hairs that is caused by the species of genera Mecrosporum and Trichophyton. It commonly affects children. Black dot ringworm (BDR) can be caused by Trichophyton tonsurans and Trichophyton violaceum. We report a 82-year-old woman with diffuse hair loss and black dots on the frontal scalp, and an erythematous annular scaly patches on the forehead. Endothrix invasion of the hair was shown on the 20% KOH mount. In fungus culture, slow growing violaceous verrucous colonies were obtained from the scalp and face. Microscopic findings revealed irregular branching hyphae and numerous chlamydospores. Histologic findings of the scalp showed numerous PAS positive fungal elements in the hair. Griseofulvin was administrated at the dose of daily 1000mg for 3 weeks, but no clinical and mycological improvement were obtained and tenderness and pustules were developed. Terbinafine at the dose of daily 250mg was administrated for 6 weeks, and clinical and mycologic improvement were obtained and damaged scalp hairs were replaced by intact hair shaft. There has been no recurrence for 8 months. To our best knowledge, this is the first case of BDR caused by T. violaceum in the Korean literature.

A Comparative Study for Diagnosing Onychomycosis Using KOH Smear, Fungal Culture, KONCPA and Fungi-Fluor(R) Stain / 대한의진균학회지

BACKGROUND: Onychomycosis is common nail problem and requires administration of antifungal agent for long period. But several cutaneous diseases can produce similar nail changes and an inexpensive, quick and sensitive test is essential for screening nail specimens. Recently, there have been several reports of new method for diagnosing onychomycosis and fungi-Fluor(R)stain, which had been used to detect fungal elements in the tissue, was not used for diagnosing onychomycosis. OBJECTIVE: This study was undertaken to evaluate the usefulness of the new method using Fungi-Fluor(R)solution for the diagnosis of onychomycosis, and compare with other methods. METHODS: During the study period, nail samples obtained from 72 patients with onychomycosis were tested for Fungi-Fluor(R)solution and the results of that were compared with those of KOH smear, fungal culture and KONCPA test. RESULTS: The results of this study are summarized as follows: 1. The positive rates of conventional KOH nail scraping preparation, fungal culture, KONCPA and Fungi-Fluor(R)staining were 47.2%,40.3%, 77.8%, and 86.1%, respectively. 2. Fungi-Fluor(R)staining proved to be less time-consuming than KONCPA test. 3. Compared to KONCPA and Fungi-Fluor(R)staining, KOH preparation and fungal culture showed high false positive rate. 4. Though both KONCPA and Fungi-Fluor(R)staining showed higher positive rate in toenail than fingernail, there were no statistic significance. CONCLUSION: The Fungi-Fluor(R)solution staining is rapid, inexpensive, and highly sensitive method to detect fungal elements in the nails.

A Case of Multiple Agminated Spitz Nevi Showing Desmoplastic Changes

We report a case of multiple agminated Spitz nevi in a 16-year-old boy who presented with multiple nodules on the right side of his face. His past history revealed that there had been erythematous and brown colored papules on the same site at the age of four. At that time one lesion was excised and histopathological findings showed fairly well circumscribed spindle and epithelioid cell nests consistent with a Spitz nevus. Twelve years later, he presented with multiple agminated brown to black colored nodules on the face. Microscopic evaluation revealed nevus cells diffusely distributed throughout the dermis showing no or little junctional activity. In addition, these cells were embedded in a strikingly desmoplastic stroma which consisted of acellular collagen fiber. Immunohistochemical staining for S-100 protein was positive. To our knowledge this is the first report of multiple agminated Spitz nevi in Korea.

A Clinicopathological Study of the Pedunculated Lipofibromas: A comparison with Nevus Lipomatosus Cutaneous Superficialis / 대한피부과학회지

No abstract available.

Immunohistochemical Study on Expression of Transforming Growth Factor-betas in Keratoacanthoma and Squamous Cell Carcinoma / 대한피부과학회지

BACKGROUND: Because of the clinical and histological similarities of keratoacanthoma(KA) and squamous cell carcinoma(SCC), it is often difficult to differentiate. Transforming growth factor-betas (TGF-betas) are the multifunctional peptides that regulate the cellular growth and differentiation. It has been known that the isoforms of TGF-beta(TGF-beta1, TGF-beta2, TGF-beta3) are differently expressed in human cancers such as basal cell carcinoma, pancreatic cancer, thyroid cancer, etc. OBJECTIVE: The purpose of this study was to examine the expression patterns of TGF-beta isoforms on KA and SCC using the immunohistochemical staining method with anti-TGF-betas antibodies and to evaluate the usefulness of this method in distinguishing each other. METHODS: We performed immunoperoxidase staining(LSAB technique) using polyclonal anti-TGF-beta1, b2, and b3 antibodies from the formalin-fixed, paraffin-embedded biopsy specimens obtained from 11 patients with KA, 11 pntients with SCC, and 10 healthy volunteers. RESULTS: In the normal skins, TGF-beta1, b2 and b3 were almost negative or only weakly positive in the epidermis, whereas TGF-beta3 was moderately to strongly positive in the suprabasal layer. In KAs, the expression patterns of TGF-beta1, b2, and b3 were similar to those of the normal skins. In SCCs, however, the expression of TGF-beta1 was increased and TGF-beta3 was decreased compared with the normal skins. CONCLUSION: In these results, the immunohistochemical staining using the anti-TGF-betas antibodies, especially anti-TGF-beta1 and b3, can be used for the differentiation of KA and SCC. Also, it can be suggested that the charige of expressions of TGF-beta isoforms in the epidermis may play an important role in the carcinogenesis of SCC.

A Study on the Diagnostic Value of Fungi-Fluor(R) Solution Staining in the Superficial and Deep Mycoses / 대한피부과학회지

BACKGROUND: Mycoses of deep tissues requir e prompt recognition and early institution of treatment. Sometimes, it is quite difficult to find fungal elements in tissue section with special stains and to culture on Sabouraud media. Previously it has been shown that Fungi-Fluor(R) solution (calcofluor white) bind t fungi present in frozen and paraffin tissue sections. Fungi present in such specimens stained with Fungi-Fluor(R) solution have a distinct green-blue fluorescence when examined by fluorescent microscopy. OBJECTIVE: The purpose of this study is to evaluate the diagnostic value of the Fungi-Fluor(R) solution for detecting fungal element in the tissue. METHODS: Fungi-Fluor(R) staining was done with a paraffin-embedded tissue section of several superficial and cutaneous deep mycoses. Then we viewed this through a fluorescent microscope with excitation of 250-400 nm and compared these staining results to PAS staining. RESULTS: The results of this study are summarized as follows : 1. In the several superficial mycoses such as tinea corporis & tinea capitis, Fungi-Fluor(R) staining method revealed more fungal elements with high sensitivity compared to PAS stain. 2. In the several cutaneous deep mycoses such as sporotrichosis, Fungi-Fluor(R) staining method revealed more fungal elements than PAS stain, and revealed some fungal elements which were not detected by PAS stain. CONCLUSION: The Fungi-fluor staining solution is a rapid, inexpensive, highly sensitive method to detect fungal element in the tissue.

A Clinicopathological Study of the Multiple Trichoepitheliomas / 대한피부과학회지

BACKGROUND: The diagnostic dilemma in differentiation between multiple and solitary trichoepitheliomas from basal cell carcinoma(BCC) is well documented. Some authors reported that up to 35% of trichoepitheliomas were misdiagnosed initially as BCC, especially the keratinizing variant. OBJECTIVE: The purpose of this study was to review the clinicopathological characteristics of the multiple trichoepitheliomas and to suggest specific findings and useful special staining methods for differentiating from BCC. METHODS: We reviewed 14 cases of multiple trichoepitheliomas from a clinicopathological aspect. We performed H&E, periodic acid Schiff, Giemsa, Fite, and alcian blue staining using the formalin-fixed paraffin-embedded samples of multiple trichoepitheliomas. RESULTS: The average age at onset was 24.7 and 78.6% of the cases showed autosomal dominant inheritance patterns. The sites of frequent involvement were the nasolabial folds and nose, and the average size of the lesions was 4.3 x 4.3 mm. The most important histopathological finding in differentiation was papillary mesenchymal tissue, and this was well observed with the Giemsa stain. Several other findings were also useful in differentiation, such as stellate structures in cystic walls, parakeratosis and eosinophilic necrotic bodies in the cystic walls, primitive hair follicles, epidermal connections, and mast cell infiltration. CONCLUSION: Several staining methods, such as the Giemsa, periodic acid Schiff, Fite, and alcian blue stains, were useful in differentiating the trichoepitheliomas from BCCs.

A Case of Pedunculated Pigmented Eccrine Poroma Combined with Congenital Melanocytic Nevus on the Scalp / 대한피부과학회지

It has been generally assum d that eccrine poroma arises from acrosyringium, the epidermal sweat duct unit. Eccrine poroma mainly involves the non hairy surfaces of the skin, but it has also been found on hair-bearing areas. One of the characteristics of this structure is absence of melanocytes and melanin granules arnong its cells. However a complete absence of melanocytes and melanin granules in eccrine poroma is not invariable and a few reports of such an occurrence have been presented. The authors report herein a case of unusual and rare eccrine poroma. The eccrine poroma had melanin pigment and melanocytes, was pedunculated and occurred on the parietal scalp which was the unusual site of involvement. The eccrine poroma was also combined with a pedunculated congenital melanocytic nevus on the supraauricular scalp.

A Case of Idiopathic CD4 + T Lymphocytopenia Associated with Kaposi's Sarcoma / 대한피부과학회지

Idiopathic CD4+ T lymphocytopenia (ICL) is a new disease entity characterized by depletion of helper T cells apparently without any evidence of HIV infection. We report a case of ICL associated with Kaposis sarcoma (KS) and pneumocystis carinii pneumonia (PCP) in a 34-year old woman. She developed violaceous, protruding masses on scalp, back, both extremities, palms, soles, left. first toe and peritonsillar region for 2 months. These lesions were confirmed as KS by histopathologic findings. Chest X-ray and HRCT findings represented PCP and KS. Absolute deficiency of CD4+ T cell was detected in the count of T cell subsets. Serologic tests for HIV-1, 2 and HTLV I, -II were negative. And she was absent any defined immunodeficiency or therapy associated with decreased levels of CD4+ T cells. By CDC criteria, a diagnosis of ICL was made. Because of aggravation of PCP and lung involuement of KS, she died at 22nd day after admission.

A Case of pseudoglucagonoma Syndrome Treated with Medium-chain Triglyceride / 대한피부과학회지

Necrolytic migratory erythema is a rare, distinctive, necrotizing cutaneous eruption usually associated with glucagonoma, an alpha-cell tumor of the pancreas. Other clinical features include ane- mia, diabetes mellitus and weight loss. However, it also occurrs without the pancreatic glucagonoma. So this rare condition is called pseudoglucagonoma syndrome, and has been described in association with chronic hepatic diseases, malabsorption with villous atrophy, chronic pancreatitis, celiac sprue, hypoproteinemia and odontogenic infection. We report a case of pseudoglucagonoma syndrome induced by malnutrition without glucagonoma. A 28-year-old Korean female was referred to our department complaining of multiple erythematous, desquamative, crusted and erosive patches on the extremities, and diffuse scalp alopecia for 5 years. She also had perianal erosion, angular cheilitis without glossitis, amenorrhea, axillary and pubic hair loss, and weight loss. Six years previously she had had Whipples operation for a pancreatic solid and papillary neoplasm. The laboratory data showed hypoalbuminemia, essential fatty acid deficiency, diabetes mellitus and slightly high levels of zinc and glucagon. A skin biopsy showed irregular acanthosis, epidermal edema and pallor, dyskeratosis, areas of superficial epidermal necrosis and vascular dilatation of the papillary dermis. The patient improved dramatically after intravenous hyperalimentation and oral intake of mediurn chain triglyceride. For 2.5 years she has taken medium-chain triglycerides without any other treatment, and no side effects on recurrence has been observed.

A Case of Multiple Histiocytomas in a Healthy Person / 대한피부과학회지

Epidermolysis bullosa acquisita(EBA) is a rare chronic subepidermal bullous disease wit,h autoantibodies to type VII collagen. Clinically, EBA usually begins after the age of 50 with pruritic vesicle and blister formation often on traumatized skin and leaves atrophic scars and milia. A 48-year-old woman visited our department with a 5 month history of a generalized pruritic blistering eruption that began on the scalp and spread to the face, trunk, extremities, and lip. The biopsy specimen revealed dermoepidermal separation, infiltration of perivascular mononuclear cells. Direct immunofluorescence(DIF) showed positive linear deposition of IgG at the BMZ. Bullous pemphigoid was diagnosed and treated with prednisolone 20-40mg daily. The skin lesions were improved after 2 week. During follow-up, trauma-induced vesicles occurred frequently and healed with remaining malia and scars. The biopsy specimen of trauma induced vesicles revealed subepidermal blisters and inflammatory cell infiltration in the dermis. DIF of perilesional skin showed positive linear deposition of IgG at the BMZ. DIF of salt split skin showed linear IgG deposits on the dermal floor. EBA was confirmed.

A Case of Generalized Annular Lichen Planus Controlled by Erythromycin / 대한피부과학회지

A 69-year-old man presented with annular lichen planus involving both forearms, hand dorsa, wrists, inner sides of the thighs, knees and ankles. He was treated initially with systemic corticosteroids and etretinate, but rernission and recurr ence of the skin lesions were observed. During the follow-up, we found erythrasma on all his toewebs and both soles. After administration of erythromycin for the treatment of erythrasma, lesions of the lichen planus rapidly improved. Five months later, some lesions of lihen planus and erythrasma had recurred. After administration of erythromycin, the lesions of lichen planus improved again. No recurrence was observed for the following 8 months. We suspect that eradication of the chronic focus of infection and the anti-inflammatory effect, of erythromycin may lead to supression of abnormal immunological reactions and resolution of lichen planus.

Quality of Life in Patients with Onychomycosis: Preliminary Study / 대한의진균학회지

BACKGROUND: Onychomycosis is a common fungal nail infection. Characteristic features include ungual and subungual hyperkeratosis, discoloration, onycholysis, nail dystrophy, and periungal pain which may cause cosmetic, social, and psychologic problem to the patients. OBJECTIVE: Our purpose is to evaluate quality of life in patients with onychomycosis. METHOD: We interviewed 100 patients with onychomycosis which was diagnosed by clinical finding and KOH preparation. RESULT: Frequently observed signs and symptoms of onychomycosis were discoloration of nail, hyperkeratosis, nail dystrophy, onycholysis, periungual pain, and periungual inflammation, in descending order Source of infection suspected by patients included military service, shoes, tines pedis, prolonged contact with water, trauma, etc. Most patients suffered from problems with daily and social activity, and psychologic problem at the rate of 64%, 58%, 66%, respectively. Patients who wanted to take medication or treatment were 73%, but they also had several worries about treatment. CONCLUSION: Many patients with onychomycosis suffered from problems with daily and social activity, and psychologic problem. Therefore, more attention should be paid to the patients with onychomycosis as the development of cultural, social, and economic status.