Jae Bok Jun

Decreasing Prevalence of Microsporum canis Infection in Korea: Through Analysis of 944 Cases (1993–2009) and Review of Our Previous Data (1975–1992)

Since 1957, Microsporum (M.) canis has been one of the common causative agents of dermatophytosis in Korea. We analyzed 944 patients infected with M. canis who attended outpatient clinic over a 17-year period (1993–2009). M. canis infections were diagnosed by mycological examinations, including direct microscopic examinations with 15% KOH and cultures on potato dextrose agar complemented with 0.5% chloramphenicol. Mycological examinations confirmed 164,903 cases of dermatophytosis, 944 (0.6%) of which were M. canis infections. The annual prevalence of patients with M. canis infection was the highest in 2002 (91 cases). Then, the prevalence of patients with M. canis infection markedly decreased until 2008 (15 cases). The ratio of male to female patients was 0.65:1, but the ratio in children under the age of 15 was 1.14:1 and was 0.20:1 in adults. Seasonally, 274 cases occurred in winter, showing higher incidence than in other seasons. There was a difference in the clinical forms of M. canis infections between children and adults; tinea (T.) capitis was the most common form in children, but T. corporis was the most common in adults. We demonstrate that the decreasing prevalence of M. canis infections over the study period has been noted in Korea.

Outbreak of rat mite dermatitis in medical students

Background The tropical rat mite, Ornithonyssus bacoti (O. bacoti), is an ectoparasite on many rodents, but when the rodent is not available, humans may become the victim of the mites bite. The bite induces a nonspecific dermatitis; therefore, it is not easy to diagnose rat mite dermatitis unless the parasites are found.

Decreasing Incidence of Trichophyton mentagrophytes in Korea: Analysis of 6,250 Cases during the Last 21-Year-Period (1992-2012)

Trichophyton mentagrophytes is the second common dermatophyte in Korea. However, few reports have been issued on the epidemiological and mycological characteristics of T. mentagrophytes in Korea based on long-term, large-scale study. The purpose of this study was to elucidate the epidemiological and mycological characteristics of T. mentagrophytes in Korea. During the 21-yr-period from 1992 to 2012, 6,250 patients with T. mentagrophytes were surveyed to determine annual incidence and the distribution of subjects by age, sex, season, involved sites, and place of residence. T. mentagrophytes infections were confirmed by fungal culture. In addition, the colony appearance of T. mentagrophytes was classified as granular, persicolor, powdery, or downy. Epidemiological analysis showed that annual incidence reached a peak in 2005, and then gradually decreased. T. mentagrophytes infection was most common in July, and was found predominantly in middle-aged adults, especially in those in their forties. Mycological analysis showed a powdery colony appearance was the most common, followed by persicolor and granular colonies. Toewebs were most frequently involved. This investigation on T. mentagrophytes provides insights into its incidence and characteristics. Graphical Abstract

A Case of Dowling‐Degos Disease Suggesting an Evolutional Sequence

We report a 47‐year‐old woman who presented with asymptomatic reticulate hyperpigmentations on the neck, lateral face, axillae, trunk, inguinal areas, and dorsa of both hands and feet. We thought it was an unusual case in the spectrum between the pole of Dowling‐Degos disease (DDD) and that of reticulate acropigmentation of Kitamura (RAK). Another interesting point was that the biopsied specimens from the abdomen, neck, and axillary lesions showed somewhat different histopathologic features from typical DDD, suggesting an evolutional sequence. From these findings we suggest that a lichenoid inflammation may be responsible for the typical maculo‐papular lesions of DDD.

The Epidemiology of Dermatophyte Infection in Southeastern Korea (1979~2013)

Background: Dermatophytosis is common worldwide and isbelieved to affect more than 20-25% of the world’s population. The epidemiology of dermatophyte infection is influenced by variable factors. Objectives: To investigate the epidemiology of fungal skin infections through a retrospective analysis of patient’s medical records between 1979 and 2013. Methods: Of total 4,275,715 patients, 415,526 patients with clinically suspicious fungal infection were collected at Catholic Skin Disease Clinic in Daegu. KOH examination and culture were performed. Of 415,526 patients, 131,440KOH- and culture-proven patients were included in this study. Results: The annual number of patients with dermatophytosis ranged from 1,973 to 6,166 between 1979 and 2013. Trichophyton (T.) rubrum was the most commonly identified dermatophyte, followed by T. mentagrophytes, Microsporum (M.) canis, and Epidermophyton (E.) floccosum. T. rubrum infection was found predominantly in thirties, T. mentagrophytes infection in forties, and M.canis and T. tonsurans infection in teenagers. T. rubrum and T. mentagrophytes infection were most commonly seen in summer. M. canis infection was most commonlyseen in winter and T. tonsurans infection in spring and winter. The most common site was toe web in T. rubrum and T. mentagrophytes infection, scalp in M. canis infection, and trunk in T. tonsurans infection. Conclusion: This study will provide valuable information on current epidemiological trends for fungal infections in Korea.

Skin Infection due to Trichophyton tonsurans Still Occurs in People in Korea but not as Outbreaks

Since 1995, Trichophyton tonsurans has been one of the causative agents of dermatophytosis in Korea. Herein we evaluate 77 patients infected with T. tonsurans who visited an outpatient clinic between 2004 and 2014. Infections due to T. tonsurans were diagnosed by mycological examination, which included direct microscopic examination using 15% KOH and culture in potato dextrose agar complemented with 0.5% chloramphenicol. The annual prevalence of infection due to T. tonsurans was the highest in 2014 (15 cases) but remained constant in non-gladiators between 2004 and 2014. The ratio of male to female patients was 1:0.3. The spring season presented the highest incidence compared with other seasons, with 27 cases. The incidence of infections due to T. tonsurans among gladiators was highest in spring compared with the other seasons whereas the incidence in non-gladiators was the highest in the winter. The body site most commonly affected was the face. Tinea corporis was the most common subtype of dermatophytosis caused by T. tonsurans. Herein, we demonstrate that the prevalence of infection with T. tonsurans remain constant throughout the study period in Korea.

Tinea Faciei in a Mother and Daughter Caused by Arthroderma benhamiae

Vol. 30, No. 2, 2018 241 Received December 27, 2016, Revised March 15, 2017, Accepted for publication April 9, 2017 Corresponding author: Weon Ju Lee, Department of Dermatology, Kyungpook National University Hospital, 130 Dongdeok-ro, Jung-gu, Daegu 41944, Korea. Tel: 82-53-420-5838, Fax: 82-53-426-0770, E-mail: weonju@knu.ac.kr This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/ licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. Copyright

Low But Continuous Occurrence of Microsporum gypseum Infection in the Study on 198 Cases in South Korea from 1979 to 2016

Background Microsporum gypseum has been isolated from South Korea since 1966. However, the incidence of M. gypseum infection is very low. Objective The aim of this study is to add massive data on M. gypseum to the literature and to provide useful information on clinical and mycological characteristics of M. gypseum. Methods We retrospectively analyzed data of 198 cases infected with M. gypseum from 1979 to 2016. The identification of M. gypseum was done with mycological examination using 15% KOH preparation and potato corn meal tween 80 agar culture media. Results The incidence of M. gypseum infection was very low in South Korea, showing a tendency to decrease. Out of 198 cases, men were 94 cases (47.5%) and women were 104 cases (52.5%). Mean age of all patients was 29.83 years old: 24.97 years old in men and 34.22 years old in women. M. gypseum infection occurred most frequently in September (16.7%) and August (16.2%). The most common clinical type of M. gypseum infection was tinea corporis (38.4%). Conclusion M. gypseum infection shows very low incidence but still remains around us until recent years. We should keep in mind the characteristics of M. gypseum.

A Case of Phaeohyphomycosis on the Wrist: Identification of Exophiala spinifera in Korea

232 Ann Dermatol Received December 27, 2016, Revised March 26, 2017, Accepted for publication March 28, 2017 Corresponding author: Weon Ju Lee, Department of Dermatology, Kyungpook National University Hospital, 130 Dongdeok-ro, Jung-gu, Daegu 41944, Korea. Tel: 82-53-420-5838, Fax: 82-53-426-0770, E-mail: weonju@knu.ac.kr This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/ licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. Copyright

Regression of an acral lentiginous melanoma with an immunotherapy using a Mycobacterium tuberculosis-extracted polysaccharide complex (Tubercin)

A 77‐year‐old‐female presented with a painless, pigmented lesion, which had been present for approximately 10 years but had increased significantly in size during the last 3 months. Her past history was unremarkable, but she had been a farmer for more than 50 years and was routinely exposed to excessive amounts of sunlight. On examination, a lesion measuring 11 × 15 mm was noted on the base of left thumb. The lesion was black, slightly elevated and irregularly shaped with a relatively demarcated border. Histological examination of the biopsy specimen was consistent with an acral lentiginous melanoma (ALM) with a thickness of 4 mm. Whole body computed tomographic examination and bone scan demonstrated no distant metastases.