Ochanomizu Institute for Medical Mycology and Allergology


Ochanomizu Institute for Medical Mycology and Allergology

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PubMed | Tokyo Women's Medical University and Ochanomizu Institute for Medical Mycology and Allergology
Type: Journal Article | Journal: The Journal of dermatology | Year: 2016

The Dermatophyte Test Strip visualizes mycotic antigens by immunochromatography. It allows easy and fast detection of dermatophytes. A multicenter, single-arm, comparative clinical study was designed to evaluate the capacity of Dermatophyte Test Strip to detect dermatophytes in suspected tinea unguium specimens in comparison with direct microscopy and polymerase chain reaction (PCR). Signed consent was obtained from 222 subjects and all subjects completed the study. With the Dermatophyte Test Strip, dermatophytes were detected in 201 of 222 (90.5%) specimens but not in 21 of 222 (9.5%) specimens. With direct microscopy, dermatophytes were detected in 170 of 222 (76.6%) specimens but not in 52 of 222 (23.4%). Of the 45 specimens that showed inconsistent results between the two methods, PCR gave further results for 40 specimens, of which 37 (92.5%) specimens were positive and three (7.5%) were negative for dermatophytes. The positive concordance rate, negative concordance rate and overall concordance rate between the Dermatophyte Test Strip and direct microscopy were 81.1%, 66.7% and 79.7%, respectively. When inconsistent results were corrected using the results of PCR, these rates were 97.5%, 71.4% and 95.0%, respectively. When five specimens that could not be tested by PCR because no piece for the PCR test was left were excluded from analysis, these rates were 99.0%, 78.9% and 97.2%, respectively. The present results indicate good detection capacity of the Dermatophyte Test Strip. The Dermatophyte Test Strip provides a reliable, convenient and quick method to test for tinea unguium.

Noguchi H.,Noguchi Dermatology Clinic | Noguchi H.,Kumamoto University | Miyata K.,Kumamoto University | Sugita T.,Meiji Pharmaceutical University | And 2 more authors.
Japanese Journal of Medical Mycology | Year: 2013

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 664.4mm2 to 481.0mm2, 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.

PubMed | Noguchi Dermatology Clinic, Kumamoto University, Nihon University and Ochanomizu Institute for Medical Mycology and Allergology
Type: Journal Article | Journal: The Journal of dermatology | Year: 2016

The patient was a 73-year-old healthy female farmer who had been treated with terbinafine for 25.5 months by a primary physician. She exhibited a discoloration and thickening of the right big toenail. She had no concomitant paronychia. Direct microscopy revealed chlamydoconidia and hyphae, and periodic acid-Schiff stained nail specimen showed septate hyphae. On the basis of these morphological features and gene analysis, the final diagnosis was ungual hyalohyphomycosis caused by Fusarium proliferatum. Topical application of 10% efinaconazole solution cured the disease in 10 months.

Hiruma J.,Tokyo Medical University | Hiruma J.,Ochanomizu Institute for Medical Mycology and Allergology | Kano R.,Teikyo University | Kimura U.,Nihon University | And 5 more authors.
Journal of Dermatology | Year: 2014

Trichophyton mentagrophytes were isolated from 19 of 20 guinea pigs in a children's corner of a zoo. The nucleotide sequence identity of the internal transcribed spacer region among 19 guinea pig isolates was 99%, including the reference strain of animal type 3 of T. mentagrophytes. The genomic DNA of all isolates were investigated for the mating (MAT) gene by specific polymerase chain reaction. The alpha-box gene was detected in all 19 isolates, while the high-mobility-group (HMG) gene was detected in only one of 19 isolates. Therefore, the guinea pig population harbored at least 2 MAT types of Arthroderma vanbreuseghemii. The T. mentagrophytes that was prevalent in this population may constitute a constant source of infection for persons coming into contact with guinea pigs. © 2014 Japanese Dermatological Association.

Hiruma J.,Tokyo Medical University | Kano R.,Nihon University | Harada K.,Tokyo Medical University | Monod M.,University of Lausanne | And 3 more authors.
Mycopathologia | Year: 2015

In this study, we epidemiologically investigated on clinical isolates of Arthroderma benhamiae from humans and animals in Japan by internal transcribed spacer (ITS) region sequence analysis and mating type (MAT)-specific PCR. Seven of 8 A. benhamiae isolates from a human, rabbits and guinea pigs were identified as group I (white phenotype) by morphological characters and ITS region sequence analysis. One strain isolated from a degus (Octodon degus) produced colonies with few irregular folds and yellow velvety mycelium without macro- and microconidia. This strain resembled to group II (yellow phenotype) strain. ITS sequence analysis was also 100 % identical to that of group II. MAT-specific PCR indicated that 6 of these 7 isolates of group I contained an alpha-box gene and that one strain contained high-mobility-group (HMG) gene. One strain of group II was revealed to have an alpha-box gene and no HMG gene. To our knowledge, it is the first A. benhamiae isolate of group II found in Japan. The A. benhamiae may be more widespread in worldwide than our surpassing what is common or usual or expected. © 2014, Springer Science+Business Media Dordrecht.

PubMed | Teikyo University, Ochanomizu Institute for Medical Mycology and Allergology, Tokyo Medical University and Nihon University
Type: Journal Article | Journal: Mycopathologia | Year: 2016

Infection by Trichophyton tonsurans is an emerging fungal epidemic in Japan. Itraconazole (ITZ) and terbinafine have been used for the treatment of this infection for 15years. However, patients with T. tonsurans infections have been shown to remain uncured or to become reinfected, suggesting that subclinical infection or polyphyletic strains and/or antifungal drug-resistant strains might be occurring in Japan. In this study, PCR analysis was performed to confirm the presence of the mating type locus MAT in genomic DNA from 60 Japanese clinical isolates of T. tonsurans, and to assess the previously postulated clonal origin of clinical isolates of this species. Antifungal susceptibility testing on isolates also was performed to confirm the absence of strains resistant to ITZ. PCR analysis proved that all 60 strains contained the MAT1-1 allele, while none contained the MAT1-2 allele. As determined by E-test, the mean MIC of ITZ in the 60 strains was 0.023mg/L (range 0.002-0.125mg/L). All strains of T. tonsurans isolated in Japan were clonal and were not resistant to ITZ. Therefore, dermatophytosis due to T. tonsurans is expected to respond to ITZ, since clinical isolates of T. tonsurans tested to date have been susceptible to this antifungal. This infection is proliferating as a subclinical infection in Japan.

Hiruma J.,Tokyo Medical University | Ogawa Y.,Juntendo University | Hiruma M.,Ochanomizu Institute for Medical Mycology and Allergology
Journal of Dermatology | Year: 2015

In this review, we summarize the status of Trichophyton tonsurans infection in Japan in terms of epidemiology, clinical features, diagnosis and infection control. Since approximately 2000, outbreaks of T. tonsurans infections among combat sports club members have been reported frequently, with the infection then spreading to their friends and family members. The most common clinical features of T. tonsurans infection are tinea corporis, which is difficult to differentiate from eczema, and tinea capitis. Tinea capitis is classified as the seborrheic form, kerion celsi form or "black dot" form, although 90% or more of patients are asymptomatic carriers. The diagnosis of symptomatic T. tonsurans infection is established by potassium hydroxide examination and fungal culture. However, because there are many asymptomatic carriers of T. tonsurans infection, tests using the hairbrush culture method are necessary. An increase in asymptomatic carriers of T. tonsurans makes assessment of the current prevalence of the infection challenging and underscores the importance of educational efforts and public awareness campaigns to prevent T. tonsurans epidemics. © 2015 Japanese Dermatological Association.

Sadamasa H.,Juntendo University | Hirose N.,Juntendo University | Hiruma M.,Ochanomizu Institute for Medical Mycology AND Allergology | Ikeda S.,Juntendo University
Skin Research | Year: 2015

We conducted infection control against Trichophyton tonsurans infections based on the guidelines. The subjects were judo experts affiliated with the University Judo Federation of Tokyo during the period from 2008 to 2013. A hairbrush test was performed every April, and positive subjects received treatment. The following results were obtained: On average, 64.9% of subjects had a history of tinea, and the percentage of subjects positive for the hairbrush test was 113% in 2008 and then decreased by half. On average, 91.8% of subjects with positive cultures were asymptomatic carriers, and 0.53% of the entire population had symptoms. Regarding changes in the number of positive subjects by year in school, the percentage of subjects positive for Trichopityton tonsurans decreased as their year in school advanced. According to the results of reexaminations performed three months after treatment, 86.3% of subjects, on average, showed conversion to negativity. The guidelines are thus sufficiently effective.

Suga Y.,Juntendo University | Kimura U.,Juntendo University | Hiruma M.,Ochanomizu Institute for Medical Mycology and Allergology
Japanese Journal of Medical Mycology | Year: 2014

Onychomycosis is a common disease seen in dermatology practice. Most patients with onychomycosis opt for treatment due to the social stigma attached to the unsightly appearance, as well as the pain that can at times make walking difficult. However, in many cases, onychomycosis is resistant to oral antifungal medication, which is the first-line therapy for this disease. In recent years, we have attempted a new treatment method using a long-pulsed 1,064nm Nd:YAG laser (Cutera Inc., Brisbane, CA, USA) in refractory cases with onychomycosis. Using 1) a laser beam with a spot size of 5.0 mm and 2) sequential irradiation at low fluence, we 3) applied the laser to the infected lesions in a motion similar to showering, while maintaining a distance of several centimeters from the skin (Laser Genesis™). Treatment efficacy was assessed using nail turbidity scores on a five-point scale. Improvement in onychomycosis was noted in more than 68.8% of all cases, thus demonstrating the high efficacy of this method. No major adverse reactions were observed during the treatment period. Since its mechanism of action clearly differs from that of antifungal agents, it can be considered a useful treatment option for cases with onychomycosis resistant to antifungal therapy. Future studies should examine “combined therapy” with oral/topical antifungal agents and this laser treatment, which may provide a significant improvement in the level of satisfaction among patients with onychomycosis. © 2014, Japanese Society for Medical Mycology. All rights reserved.

Hiruma M.,Juntendo University | Hiruma M.,Meiji Pharmaceutical University | Cho O.,Meiji Pharmaceutical University | Hiruma M.,Ochanomizu Institute for Medical Mycology and Allergology | And 3 more authors.
Mycopathologia | Year: 2014

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. © 2014 Springer Science+Business Media Dordrecht.

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