[Survey of Trichophyton tonsurans Infection in the Kyushu, Chugoku and Shikoku areas of Japan].

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.

A case of black dot ringworm attributable to Trichophyton violaceum: a simple method for identifying macroconidia and microconidia formation by Fungi-Tape and MycoPerm-Blue.

An 85-year-old Japanese woman sought a dermatologic consultation for evaluation of a walnut-sized alopecia with pityroid desquamation in the parietal region of her scalp. She had been admitted to a nursing home about three months earlier, and, at that time, a thumb-tip-sized, scaly alopecia was noted. Several hairs at the site were eroded in a black dot. Direct KOH microscopy of affected hair showed large spore endothrix infection. To isolate macro- and microconidia for fungal identification, we incubated the affected hair and scales and obtained giant colonies in a special enriched medium. Using Fungi-tape and MycoPerm-Blue, we were able to collect and identify Trichophyton violaceum macro- and microconidia from the white, powdery, fluffy colony that slowly developed after about six weeks of growth on enriched medium. Over the past 20 years, only about 20 cases of tinea capitis caused by T. violaceum have been reported in Japan, and macroconidia have been identified in only 4 cases, including this one.

Genetic polymorphisms of killer cell immunoglobulin-like receptors are associated with susceptibility to psoriasis vulgaris.

To elucidate the association between killer cell immunoglobulin-like receptors (KIRs) and psoriasis vulgaris (PV), we typed 14 KIR genes in 96 Japanese cases and 50 healthy controls using PCR with sequence-specific primers (PCR-SSP). Here we report an interesting association between certain KIRs and Japanese cases with PV. The frequencies of KIR2DS1 and KIR2DL5 were significantly increased in PV cases compared with controls (KIR2DS1, 43 of 96 (45%) in cases vs 14 of 50 (28%) in controls; KIR2DL5, 46 of 96 (48%) in cases vs 15 of 50 (30%) in controls, p<0.05 for both), and the frequency of carriage of at least one presumed "B" haplotype, inferred from patterns including KIR2DL2, KIR2DL5, and/or various combinations of activating KIRs, was also statistically increased in the PV cases (53 of 96 (55%) in cases vs 18 of 50 (36%) in controls, p<0.04). The increase in KIR2DS1 has also been observed in psoriatic arthritis, another HLA-Cw6-associated disease (Martin et al, 2002). Accordingly, KIR2DS1 may be a common denominator of both diseases.

[Prevalence and patient's consciousness of tinea pedis and onychomycosis].

Epidemiological studies on tinea pedis and onychomycosis have been performed across Europe and East Asia. The prevalence of these conditions was 20%, respectively, and it increased with advancing age, more men than women had fungal infection of the feet. The prevalent predisposing factors were sports participation, average temperature, and family history of tinea pedis. The predisposing diseases were hypercholesterolemia, cardiovascular disease, diabetes mellitus, and osteoarticular disease. We conducted an epidemiological investigation to determine the prevalence and circumstances of untreated and unsuspected tinea pedis and onychomycosis. The results showed that the prevalence of occult athlete's foot was 25%, and that 59% of those cases were complicated by tinea unguium. The characteristics of patients with occult athlete's foot included a higher proportion of men and a tendency toward a low clinical score together with a high severity score. In the patient background, a strong correlation was observed between a positive KOH test result and characteristics such as past history of tinea pedis and/or onychomycosis, age, disposition of toes, and predisposing disease, as well as the type of shoes worn daily. We suspected that a patient's local and systemic conditions affected each other, creating good conditions for tinea pedis and onychomycosis so that the prevalence has increased. More understanding of occult athlete's foot will lead to prevention and improvement in treatment and diagnosis.

[A simple method to identify pathogenic fungi in Sabouraud's glucose agar slant culture using fungi-tape and MycoPerm-Blue].

Pathogenic fungi can be identified by growth in special culture medium, colony appearance based on microscopic examination of conidia and hyphae, and by molecular biological techniques. However, these methods are time-consuming and labor-intensive. We describe a simple method for identification of pathogenic fungi from Sabouraud's glucose agar slant culture, using Fungi-Tape and MycoPerm-Blue. It is rapid and easy, and permits visualization of fungal morphology. Using the Fungi-Tape and MycoPerm-Blue technique, we correctly identified 47 of 66 samples, for a 73.4% concordance with conventional identification methods. It is also noteworthy that slides prepared using this method can be stored for long periods without deterioration.

A case of multiple keratoacanthoma centrifugum marginatum: response to oral etretinate.

The patient was a 48-year-old man who had a history of colonic polyps. About 18 months before, a dark reddish nodule had appeared on his right forearm. By peripheral growth, this lesion had formed a crateriform prominence with central healing. Similar symptoms multiplied and expanded, the largest being about the size of a child's head. Given both the clinical and histologic evidence, a diagnosis of keratoacanthoma centrifugum marginatum (KCM) was made. Oral etretinate was administered, and an involution of verrucous plaque began after 4 weeks. After 8 weeks, the lesions faded, leaving pigmentation in some areas. This is a rare disorder, only 30 such cases having been reported worldwide, and the present case was the third in which oral etretinate was found to be effective.