Nippon Ishinkin Gakkai Zasshi
Online ISSN : 1882-0476
Print ISSN : 0916-4804
ISSN-L : 0916-4804
Volume 46, Issue 2
Displaying 1-14 of 14 articles from this issue
  • Jin Yu, Ruoyu Li, Glenn Bulmer
    2005 Volume 46 Issue 2 Pages 61-66
    Published: April 30, 2005
    Released on J-STAGE: December 18, 2009
    JOURNAL FREE ACCESS
    Tinea capitis is one type of superficial fungal infection which is found all over the world. The major etiologic agent of tinea capitis varies in different areas. Tinea capitis in China has unique characteristics. The epidemiology, transmission and therapy of child and adult tinea capitis in China are reviewed in this paper.
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  • Moo Kyu Suh
    2005 Volume 46 Issue 2 Pages 67-70
    Published: April 30, 2005
    Released on J-STAGE: December 18, 2009
    JOURNAL FREE ACCESS
    Phaeohyphomycosis is a mycotic disease caused by dematiaceous fungi that produce brown yeast-like cells, pseudohyphae, and irregular true hyphae in tissues. Seven Korean cases of subcutaneous phaeohyphomycosis have been reported to date, four males and three females, ranging in age from 9-84 years (mean 50.4 years). Causative organisms of subcutaneous phaeohyphomycosis were 3 of Exophiala jeanselmei, 2 of E. dermatitidis, 1 of Drechslera dematioidea and 1 of Phoma sp. Four cases of abscess and 3 cases of verrucous plaque were present as skin lesions, and were all exposed areas of the body. Patients were treated with itraconazole, ketoconazole, fluconazole or amphotericin B.
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  • Evangeline B. Handog, Johannes F. Dayrit
    2005 Volume 46 Issue 2 Pages 71-76
    Published: April 30, 2005
    Released on J-STAGE: December 18, 2009
    JOURNAL FREE ACCESS
    The warm tropical climate of the Philippines and its interaction with cultural practices, occupation and immune responsiveness contribute to the increased susceptibility of Filipinos to fungal infections. An investigation to determine the prevalence of fungal infections in dermatology training institutions over a 4-year period was conducted. The results showed that fungal infections rank as the second leading cause of consultation with a prevalence of 12.98%. Pityriasis versicolor (25.34%), tinea corporis (22.63%), tinea cruris (16.7%) and tinea pedis (16.38%) were the most frequently encountered cases. Fungal culture yield is low and Candida sp. is the most common isolate, obtained predominantly from specimens taken from the oral mucosa and nails. Candidiasis is still the most common opportunistic infection followed by coccidioidomycosis, cryptococcosis and aspergillosis. Imidazoles are the most commonly prescribed systemic and topical treatment by Filipino dermatologists. Initial data collected would serve as reference for future research and may be used to compare with epidemiologic data obtained from other Asian countries.
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  • Hiok-Hee Tan
    2005 Volume 46 Issue 2 Pages 77-80
    Published: April 30, 2005
    Released on J-STAGE: December 18, 2009
    JOURNAL FREE ACCESS
    Cutaneous fungal infections are common in Singapore. The National Skin Centre is a tertiary referral centre for dermatological diseases in the country, and sees more than 2, 500 cases of superficial fungal infections annually.
    Aim: This study analyses data collated from the centre's medical record office as well as fungal culture results from the mycology laboratory.
    Results: From 1999 to 2003, there were a total of 12, 903 cases of superficial fungal infections seen at the centre. The majority of patients (n=9335) (72.3%) were males. The most common infection was tinea pedis (n=3516) (27.3%), followed by pityriasis versicolor (n=3249) (25.2%) and tinea cruris (n=1745) (13.5%). Candidal infections were also common (n=1430), the majority of which were cases of candidal intertrigo. There were very few cases of tinea capitis, which is uncommon in Singapore. The number of cases of onychomycosis has shown a rising trend over the past 5 years. Trichophyton rubrum was the most prevalent fungal pathogen isolated from all cases of superficial fungal infections of the skin, except for tinea pedis, where Trichophyton interdigitale was the most frequently isolated organism. Dermatophytes remain the most commonly isolated fungal pathogens isolated in toenail onychomycosis, whilst Candida species accounted for the majority of isolates in fingernail onychomycosis.
    Conclusion: Current epidemiologic trends of superficial fungal infections in Singapore show some similarities to recent studies from the United Kingdom and United States.
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  • Rataporn Ungpakorn
    2005 Volume 46 Issue 2 Pages 81-86
    Published: April 30, 2005
    Released on J-STAGE: December 18, 2009
    JOURNAL FREE ACCESS
    Scytalidium dimidiatum is the leading cause of fungal foot diseases in Thailand, in contrast to similar studies in which dermatophytes have been identified as the predominant pathogens. By contrast, the prevalence of Candida albicans in our study was only 2.6-3.0%. Scytalidium fungal foot infection is clinically indistinguishable from that caused by dermatophytes and should be included as a possible cause of treatment failure in tinea pedis and onychomycosis. Without proper culture identification, clinically diagnosed patients would be treated with a standard antifungal regimen leading to minimal response and be interpreted as drug resistant cases resulting in switching of drugs and more aggressive management procedures.
    Tinea capitis is another health problem in young children. However, for Microsporum canis and some ectothrix organisms, the effectiveness of treatment may be less than endothrix infection. Griseofulvin is still the mainstay antifungal although itraconazole and terbinafine are as effective. Pulse regimen may be another option with advantages of increased compliance and convenience. Two pulses of terbinafine may be sufficient for treating most cases of Microsporum infection, although additional treatment may be needed if clinical improvement is not evident at week 8 after initiating therapy.
    Chromoblastomycosis is another subcutaneous infection that requires long treatment duration with costly antifungal drugs. The most common pathogen in Thailand is Fonsecaea pedrosoi. Preliminary study of pulse itraconazole 400mg/d 1 week monthly for 9-12 consecutive months showed promising results.
    The prevalence of Penicillium marneffei infection is alarming in HIV infected patients living in endemic areas. Diagnosis relies on direct examination of the specimens and confirmation by culture. Treatment regimens include systemic amphotericin B or itraconazole followed by long-term prophylaxis. Treatment outcome depends on the immune status of the patient.
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  • Tatsuya Kasai
    2005 Volume 46 Issue 2 Pages 87-91
    Published: April 30, 2005
    Released on J-STAGE: December 18, 2009
    JOURNAL FREE ACCESS
    To research the current status of Trichophyton tonsurans infection in Tohoku District, I sent out a questionnaire to the main dermatology clinics in the Tohoku district. The results showed this infection was found first in spring, 2001 in Miyagi prefecture, and gradually spread from southern to northern districts; the total number of patients is now 162. The number in each prefecture is as follows: Yamagata; 88, Miyagi; 68, Akita; 4, Aomori; 2. In Iwate and Fukushima, however, no cases were reported. By age distribution high school students accounted for 117 (75%), elder patients for 29 (19%), lower age children only 10, and 6 cases were uncertain. Judo players accounted for 113 (70%) and wrestlers for 39 (24%). Family infections were found in two cases. Latent infections were found in several cases, and in one case the infection continued for 2.5 years without clinical symptoms. In my clinic 30 cases were observed beginning in 2001: high school boys accounted for 11, students of a professional school 14, college student 1, adults 3, and those involved in judo 27, wrestling 2 and mixed grappling sports 2. A family infection between a father and his daughter was found. According to the observations in our cases, this fungus easily invaded the hair roots from the early stage of infection, but was not noticed by common external clinical observations. Thus, microscopic examinations are necessary throughout the therapeutic process and to make certain of a complete cure. I think also necessary is the systemic administration of terbinafine or itraconazole for 4 or 6 weeks or more even for tinea corporis. Additionally, I emphasize that culture study is indispensable to confirm the infection by this fungi.
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  • Masataro Hiruma, Yumi Shiraki, Nozomi Nihei, Nobuyoshi Hirose, Morio S ...
    2005 Volume 46 Issue 2 Pages 93-97
    Published: April 30, 2005
    Released on J-STAGE: December 18, 2009
    JOURNAL FREE ACCESS
    We conducted a questionnaire investigation to learn the incidence of T. tonsurans infection. Subjects of this investigation were 1, 060 dermatologists in 1, 060 dermatology clinics in the Kanto area to whom questionnaires were mailed. We asked each dermatologist whether he/she had experienced T. tonsurans infection cases (including suspected cases) and if so, we further asked; a. time of onset, b. number of cases, c. sexuality of the patient, d. club that the subject had joined (judo club, wrestling club or other), e. age of the subject, and f. number of cases suspected of having familial infection, the response rate was 47.5% (504 of the 1060 doctors), and 25.8% (130 of the 504) had handled T. tonsurans infection cases. The total number of patients was 707 (657 males and 50 females), with 400 (56.6%) of those in the 18 high-ranking clinics. The number of cases had increased rapidly from around 2002; 72.9% of the patients were students in high schools and universities and in 8 cases familial infection was suspected. 96.5% of the patients were in a judo or wrestling club. Our investigation revealed that this infectious disease had spread more than we had expected. It is important to develop more reliable infection control measures and to determine the actual conditions of this infection using mycological examinations.
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  • Takashi Mochizuki, Hiroshi Tanabe, Masako Kawasaki, Kazushi Anzawa, Hi ...
    2005 Volume 46 Issue 2 Pages 99-103
    Published: April 30, 2005
    Released on J-STAGE: December 18, 2009
    JOURNAL FREE ACCESS
    In June 2004, information was gathered on Trichophyton tonsurans infections, both past and current, in the Hokuriku and Kinki regions of central-western Honshu island, Japan, by questionnaires sent to 185 dermatologists who were members of the local medical mycologist associations Hokuriku Shinkin Kondan-kai and Kansai Shinkin Kondan-kai. Of the 111 (59.4%) who returned the completed questionnaire, 32 (28.8%) had seen patients infected with T. tonsurans including suspicious cases. The earliest recorded cases were linked to an endemic that occurred in 1994 or 1995 among a high school wrestling team in Toyama. The majority of the dermatologists saw their first case between 2001 and 2003. When the patients were grouped according to contact sports, judo players formed the largest group, followed by wrestlers. When grouped according to age, high school students formed the largest group, but the endemic had also expanded among junior high school students and adults, and there was one nursery school child who was a member of a judo club. Seventy-four of the dermatologists were sent sterilized hairbrushes to collect samples from patients suspected as having tinea capitis during July and September 2004. Trichophyton tonsurans was detected in samples from 6 patients.
    To investigate the molecular epidemiology, 71 of the clinical strains of T. tonsurans isolated from the Hokuriku and Kinki regions were analyzed using restriction fragment length polymorphisms of the nontranscribed spacer regions of ribosomal RNA genes. With the restriction enzyme Mva I, two molecular types were detected among the strains, indicating that the causative agents of the endemic were derived from different origins.
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  • Katsutaro Nishimoto, Kizou Honma, Hidekazu Shinoda, Yumie Ogasawara
    2005 Volume 46 Issue 2 Pages 105-108
    Published: April 30, 2005
    Released on J-STAGE: December 18, 2009
    JOURNAL FREE ACCESS
    A survey on the infestation of dermatophytosis caused by T. tonsurans was made by inquiry to dermatologists. Patients strongly suggestive of having skin lesions due to T. tonsurans were seen in all areas examined, and were mainly schoolboys, including those practicing judo, of high schools and junior high schools. In Nagasaki, a mycological examination was done on 21 judo students and their teacher in a high school in which a patient with T. tonsurans infection was mycologically confirmed and treated by antimycotics. Mycological examinations failed to isolate T. tonsurans, but even after the examination sporadic cases were reported among the group members. In Saga prefecture, Kyushu, a mycological screening for T. tonsurans infection among judoists and wrestlers in 13 high-schools and 7 junior high schools was done using the blush sampling method. Fifty-six strains of T. tonsurans were isolated from 248 students. The problems concerning the control of this infection were discussed.
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  • Eri Ochiai, Katsuhiko Kamei, Kenzo Hiroshima, Akira Watanabe, Yoshie H ...
    2005 Volume 46 Issue 2 Pages 109-117
    Published: April 30, 2005
    Released on J-STAGE: December 18, 2009
    JOURNAL FREE ACCESS
    Stachybotrys chartarum is a dematiaceous fungus that is ubiquitous in our living environment. This fungus has long been regarded as non-pathogenic and its inhalation effect on humans has been scarcely studied. Recently, however, epidemiologic studies on acute idiopathic pulmonary hemorrhage in infants suggested that the fungus might be potentially pathogenic to humans. To determine the pathogenicity of this fungus, its interaction with the host defense system was studied using polymorphonuclear leukocytes (PMNs) and macrophages. Histopathological analysis of mice intratracheally injected with this fungus was also performed. The results disclosed that the conidia of S. chartarum were resistant to the antifungal activities of alveolar macrophages in terms of phagocytosis, killing and inhibition of germination. However, the conidia could not survive in the lungs of mice when injected intratracheally. Lavage fluid of mycelia that contained the dark slimy material coating the surface of conidia showed cytotoxic activity against macrophages and PMNs. Intratracheal injection of conidia in mice resulted in intraalveolar infiltration of PMNs. When using multiple injections during a 3-week period, strong eosinophilic infiltration into the proximal alveoli and perivascular tissues was observed. Our results suggest that inhalation of conidia may cause serious damage to the human lung, particularly when repeated.
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  • Nobuyoshi Hirose, Yumi Shiraki, Masataro Hiruma, Hideoki Ogawa
    2005 Volume 46 Issue 2 Pages 119-123
    Published: April 30, 2005
    Released on J-STAGE: December 18, 2009
    JOURNAL FREE ACCESS
    Background: The prevalence of the infectious disease Trichophyton tonsurans is rapidly increasing in Japan, particularly in athletes of these sports such as judo. Recognition of the current prevalence of this disease not only in athletes of these sports but also in other athletes is important to prevent its further spread.
    Subjects and Methods: In November, 2002 we used a questionnaire survey and hairbrush culture to identify hair dermatophyte carriers among 31 members of a university judo club. The dermatophyte carriers received antimycotic therapy, and all participants were taught infection prevention. Repeat screenings of the judo club members were performed 9 times over the following 18-month period. In addition, from November, 2003 to February, 2004 we screened 466 students of other university sports clubs for hair dermatophytes using the questionnaire survey and hairbrush culture technique.
    Results: (1) Initially, we identified 11 (35%) of 31 members of the judo club as dermatophyte-positive by hairbrush culture. These dermatophyte carriers received antimycotic therapy, and implementation of infection prevention measures by all club members was initiated. Members continued to participate in matches and group judo practices under daily instructions for infection prevention. Tests performed on 9 occasions over a 1.5-year period following the initial testing showed all members of the judo club to be dermatophyte-negative and with no signs of tinea corporis. (2) Using a questionnaire and the hairbrush culture technique, we screened 466 members of other sports clubs, including 138 students who had weekly judo lessons and 185 students who were living in a dormitory. All were dermatophyte-negative by hairbrush culture, and no participant acknowledged any history or presence of eruptions suggestive of tinea.
    Conclusions: Our investigation suggests that the current spread of T. tonsurans infection in Japan is occurring mainly in athletes of high-contact sports such as judo. The successful control of this disease by the judo club in our university suggests that spread of the infection can be prevented without requiring that training be discontinued in a group fully informed about the disease.
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  • Reiko Tanaka, Junko Ito, Ayaka Sato, Kazuko Nishimura
    2005 Volume 46 Issue 2 Pages 125-128
    Published: April 30, 2005
    Released on J-STAGE: December 18, 2009
    JOURNAL FREE ACCESS
    To evaluate a newly developed identification kit, the RID Zyme CAS test for Candida albicans, 1136 C. albicans and 403 non-albicans Candida strains were tested. Distinction of medically important non-albicans strains, with the exception of C. dubliniensis, was obtained. These results show that this new kit is simple and effective for the identification of C. albicans in clinical samples. Furthermore, the one hour period for identification makes it very attractive.
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  • Keisuke Nagao, Takashi Sugita, Takeshi Ouchi, Takeji Nishikawa
    2005 Volume 46 Issue 2 Pages 129-132
    Published: April 30, 2005
    Released on J-STAGE: December 18, 2009
    JOURNAL FREE ACCESS
    Trichophytia profunda acuta of the glabrous skin (TPAGS) arose in a 67-year-old Japanese man. The patient presented indurated erythematous plaques and nodules on his left forearm. Direct microscopic examination of the scale in KOH preparation was negative for fungal elements, and culture for dermatophytes was also negative. Although fungal infection could not be proven in hematoxillin-eosin stained sections, deep-cut sections of the biopsied skin lesion with PAS stain revealed the ectothrix presence of fungal elements. Nested PCR was done with Trichophyton specific primers directed to internal transcribed spacer gene 1 (ITS1), using template DNA obtained from formalin fixed, paraffin embedded skin sections. A single band corresponding to T. rubrum was obtained, and the etiological agent was thus identified. KOH tests and cultures may often turn out unsuccessful, perhaps reflecting the hair follicle dominant fungus growth in TPAGS. Although these tests are most important for diagnosis of TPAGS, nested PCR using paraffin embedded skin sections may be an alternative method to identify the etiological agent.
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  • Soji Iida, Tamae Imai, Toyoko Oguri, Katsuko Okuzumi, Ademar Yamanaka, ...
    2005 Volume 46 Issue 2 Pages 133-137
    Published: April 30, 2005
    Released on J-STAGE: December 18, 2009
    JOURNAL FREE ACCESS
    The internal transcribed spacer (ITS) region including 5.8S rDNA sequences of 58 isolates of Candida parapsilosis in Brazil and Japan was analyzed. Although most of the C. parapsilosis strains tested were confirmed to belong to three already reported genetically distinct groups (I, II and III) based on their ITS region sequences, 5 strains of the Brazilian isolates showed different sequences from those heretofore reported and suggested a presence of new genotype. For these strains of C. parapsilosis, we proposed a new genetic group (IV). The sequence similarities of this new group of IV to I, II and III were 87.4%, 94.7% and 87.3% in the ITS1 region, respectively. Genetic diversity in ITS regions of the remaining C. parapsilosis strains in Brazil and Japan was also discussed.
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