韓国における真菌症

Abstract

In Korea, ringworm, tinea versicolor and cutaneous candidosis are the principal fungal infections. Around the outbreak of the Korean War, tinea capitis was the most frequent clinical type of ringworm due to its nation-wide epidemic, but it has been rapidly reduced since 1960. In recent years, tinea pedis and manuum as a whole, occupy over half of the total cases of ringworm; tinea cruris, tineafaciei and corporis have an increasing tendency to show atypical clinical manifestations. In the last 10 years the aspect of dermatophytic flora has remarkably changed compared with that seen around World War II. While Trichophyton ferrugineum, the principal causative organism of tinea capitis and tinea corporis in the past, has been abruptly decreasing in frequency since 1960. Microsporum canis has spread all over the country and T. rubrum is increasing. The number of tinea capitis due to M. canis, which was isolated for the first time in 1957, has been increasing steadily every year especially since 1978. During 10 years from 1976 to 1985, the total number of cases with dermatophytoses observed at Chilgok Catholic Skin Clinic in Taegu was 34, 261, representing 14.2% of the total new out-patients. Of these, tinea pedis was the most frequent (40.4%), followed by tinea cruris (23.8%), tinea faciei and corporis (12.9%), tinea unguium (10.7%), tineamanuum (8.5%), tinea capitis (3.7%) and tineafavosa (2 cases). The total number of dermatophytes isolated during the same 10-year-period was 21, 754 strains, composed of T. rubrum (77.6%), T. mentagrophytes (10.8%), M. canis (7.2%), Epidermophyton floccosum (3.7%), M. gypseum (0.4%), T, ferrugineum (0.3%) and T. schoenleinii (2 strains). In viewing of teleomorphic state, M. canis exhibited only Nannizzia otae “-” mating type. Among 474 strains of T. mentagrophytes, 225 were Arthroderma vanbreuseghemii “+” mating type, with the remaining 249 being “-”. “+” Type of A. vanbreuseghemii was frequently identified in tinea pedis and unguium, while “-” type in tinea capitis, tinea faciei and corporis, tinea manuum. In case of M. gypseum, N. incurvata and N. gypsea have been isolated at almost the same rate. Sporotrichosis is rare but occurs sporadically throughout the country, showing no evidence of increasing. Inrecent years, although very rare, infections due to Cryptococcus neoformans, Phoma species, Fusarium species, Paecilomyces lilacinus, Wangiella dermatitidis have been reported. Deep mycoses seem very rare. Pulmonary infections due to Aspergillus, Cryptococcus, Candida albicans and Pseudallescheria boydii have been observed. Diseases such as tinea imbricata, tinea nigra, chromomycosis and coccidioidomycosis, which are observed in the other nations, have not been described.