We investigated the efficacy of 1064nm Nd:YAG laser for the treatment of onychomycosis caused by dermatophytes. The study population consisted of 12 patients (6 male, 6 female ; average age 53.5 years), with onychomycosis confirmed by fungal culture and/or real-time PCR identification of the pathogen. The causative agent was identified as Trichophyton rubrum in 11 cases and a mixture of T. rubrum and T. mentagrophytes in 1 case. For each patient, laser treatment was given to a single hallux nail, with turbidity at baseline affecting <75% of the nail surface and thickness at baseline <3mm. Treatment was given in 3 sessions at 4-week intervals, and nail turbidity was evaluated 3 and 6 months after the first laser treatment. After 6 months the efficacy results were as follows: 3 cases, turbidity significantly improved ( >70%) ; 2 cases, turbidity improved (50-70%), 1 case, turbidity slightly improved (30-50%) ; 5 cases, no change in turbidity (<30% improvement) ; and 1 case, turbidity worsened. Overall, the total lesion area with turbidity in 12 patients decreased from 664.4mm(2) to 481.0mm(2), corresponding to a 27.6% improvement after treatment. Pain during laser treatment was well tolerated, and all patients underwent all 3 treatments. These results suggest that the 1064nm Nd:YAG laser could be a useful treatment alternative for patients with mild onychomycosis.
Dandruff and seborrheic dermatitis are common afflictions of the human scalp caused by commensal scalp fungi belonging to the genus Malassezia. Malassezia globosa and Malassezia restricta are the predominant species found on the scalp. The intergenic spacer regions of these species' rRNA genes contain short sequence repeats (SSR): (GT)n and (CT)n in M. globosa and (CT)n and (AT)n in M. restricta. In the present study, we compared the genotypes (SSR) of M. globosa and M. restricta colonizing the scalps of patients with dandruff and healthy individuals. For M. globosa, the genotype (GT)10:(CT)8 (40.3 %, 25/62) was predominant followed by (GT)9:(CT)8 (14.5 %, 9/62) and (GT)11:(CT)8 (14.5 %, 9/62) in patients with dandruff, whereas the genotypes in healthy subjects were diverse. For M. restricta, the genotype (CT)6:(AT)6 (59.7 %, 37/62) was predominant followed by (CT)6:(AT)8 (24.2 %, 15/62) in patients with dandruff, while four genotypes, (CT)6:(AT)6 (10.5 %, 6/57), (CT)6:(AT)7 (22.8 %, 13/57), (CT)6:(AT)8 (17.5 %, 10/57), and (CT)6:(AT)10 (21.1 %, 12/57), accounted for 71.9 % of all combinations in healthy subjects. The results of this study suggest that the M. globosa genotype (GT)10:(CT)8 and the M. restricta genotype (CT)6:(AT)6 may be involved in the development of dandruff.
Summary. We examined the relationship between prevalence and severity of tinea pedis and the length of service and the width of the spaces between the toes in 74 members of the Japanese Self‐Defence Forces (SDF) undergoing special training. The subjects were divided according to the width of these spaces into: group I, wide; group II, fairly wide; and group III, closed. The severity of tinea pedis was determined by its duration and the extent of the lesions in the 49 subjects who had tinea pedis. The combined prevalence of tinea pedis and tinea unguium was 66%. There was a tendency for the prevalence to be higher in subjects who had served for 10 years or more in the SDF than in those with fewer than 10 years of service. Classified by the disposition of their toes, 10 subjects fell into group I, 34 into group II, and 30 into group III. The prevalence of 90% (27/30) in group III was significantly higher than in the other groups. A significant positive correlation was seen between length of SDF service and severity. Subjects with both a long service record and closed interdigital spaces showed both a high prevalence and marked severity. Zusammenfassung. Wir untersuchten. in welcher Weise die Häufigkeit und das Ausmaß von Tinea pedis im Zusammenhang stand mit der Länge der Dienstzeit und der Breite des Interdigitalabstandes bei 74 Mitgliedern der japanischen Selbstverteidigungstruppe (SDF) während einem Sondertraining. Die Fälle wurden entsprechend der Breite des Interdigitalabstandes in drei Gruppen eingeteilt: Gruppe I: weit; Gruppe II: mäßig weit; Gruppe III: eng. Das Ausmaß der Fußflechte von 49 Personen wurde durch die Dauer der Erkrankung und die Schwere der Läsionen bestimmt. Die Häufigkeit der Fußflechte, einschließlich Tinea unguium, lag bei 66% Bei Personen, die eine Dienstzeit von 10 Jahren oder mehr aufwiesen, schien die Häufigkeit etwas höher als bei Personen, die weniger als 10 Jahre Dienstzeit aufwiesen. Es zeigte sich eine signifikante Korrelation zwischen der Länge der Dienstzeit in der SDF und dem Ausmaß der Erkrankung. Die Häufigkeit von 90% (27/30) bei Gruppe III war signifikant höher als bei den anderen Gruppen. Personen mit langer Dienstzeit und einem engen Interdigitalabstand zeigten sowohl eine größere Häufigkeit als auch eine ausgeprägtere Schwere der Erkrankung.
The etiology of prurigo pigmentosa still remains unknown. We present a 16-year-old female patient with ketonemia caused by diabetes mellitus. The eruption subsided when blood glucose and total ketone levels were controlled by subcutaneous insulin injection. We propose that ketonemia caused by diabetes mellitus may play a role in the pathogenesis of prurigo pigmentosa.
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