Cutaneous dermatophyte infections, dermatophytosis, are common worldwide, affecting various age groups and body parts. Despite advancements in antifungal therapies, the prevalence of dermatophytosis continues to increase, posing significant challenges for diagnosis and treatment. This review provides an overview of the prevalence, clinical features, and diagnostic methods for dermatophytosis in Korea. A comprehensive review of domestic reports and research on dermatophytosis in Korea was conducted using data from KoreaMed. This study covers the various clinical presentations, age distributions, seasonal trends, and types of dermatophytes identified in different body areas. Dermatophytosis in Korea have shown changing patterns in terms of prevalence and causative species. Trichophyton rubrum remains the most common causative organism, with varying presentations depending on the site of infection, such as tinea pedis, tinea corporis, tinea capitis, tinea faciei, and onychomycosis. Diagnostic practices largely depend on the potassium hydroxide smear test, which has limited sensitivity, particularly for onychomycosis. Recent trends indicate an increase in the incidence of dermatophytosis among older adults, which may be linked to underlying health conditions and lifestyle changes. Dermatophytosis in Korea exhibit diverse clinical manifestations influenced by factors such as patient age, body site, and seasonal variation. Improved diagnostic methods are needed to enhance the accuracy and guide appropriate treatment, especially with the emergence of antifungal-resistant strains. This review aims to provide a better understanding of the current state of dermatophytosis in Korea and contribute to more effective management and prevention strategies.

Onychomycosis is a prevalent fungal infection of the nail apparatus, predominantly caused by dermatophytes. However, nondermatophytic molds, while less common, represent an increasingly recognized etiological group. Among these, Aspergillus, Scopulariopsis, Neoscytalidium, and Fusarium species are frequently implicated. Advancements in molecular diagnostic techniques have facilitated the identification of rare and emerging fungal pathogens implicated in onychomycosis. This case report details the first recorded case of onychomycosis caused by Nothophoma quercina, a fungal species that was previously recognized only as a plant pathogen. A 44-year- old male with severe atopic dermatitis receiving long-term immunosuppressive therapy with cyclosporine and dupilumab developed persistent nail abnormalities. Mycological evaluation, which included potassium hydroxide testing, fungal culture, and molecular analysis, confirmed Nothophoma quercina as the causal organism. The presence of this rare fungus in a human infection underscores the expanding spectrum of nondermatophytic onychomycosis and emphasizes the need to consider atypical pathogens in immunocompromised individuals. The growing use of molecular techniques has facilitated the detection of novel fungal species that may have been previously misidentified or disregarded using conventional methods. This case highlights the need for clinicians to exercise caution while assessing refractory onychomycosis, particularly in high-risk patients. Greater awareness and continued research into rare fungal pathogens will enhance the diagnostic accuracy and developing appropriate antifungal management strategies.

Nummular eczema (NE) and atopic dermatitis (AD) share clinical features, yet their skin microbiomes remain insufficiently characterized. This exploratory pilot study evaluated the taxonomic composition and functional potential of the skin microbiome across NE, a mixed NE/AD phenotype (Mixed NE_AD), and AD using shotgun metagenomics. Lesional swabs from Korean patients with NE (n = 8), Mixed NE_AD (n = 6), and AD (n = 5) were sequenced to assess microbial diversity, taxonomy, and functional pathways. Staphylococcus aureus predominated across all groups. NE samples were characterized by the higher relative abundance of environmental taxa, wherein Delftia acidovorans was observed only in NE samples in this cohort, and Kocuria palustris diminished sequentially across the Mixed NE_AD and AD phenotypes. Mixed NE_AD exhibited greater intra-genus Staphylococcus diversity. Despite non-significant overall diversity differences, partial ecological separation was noted. Functionally, descriptive differences in metabolic potential were observed, with NE showing trends toward biosynthetic and oxidative stress-associated pathways and AD showing trends toward degradation-related pathways. Mixed NE_AD showed intermediate characteristics. Although these differences did not reach statistical significance after correction for multiple testing, these findings provide preliminary evidence for microbiome-based stratification of eczematous disorders, warranting larger cohort validation.

Scabies, caused by Sarcoptes scabiei, is a globally prevalent ectoparasitic infestation associated with intense pruritus and secondary bacterial infection, yet the molecular composition of the skin microbiome during active infestation remains poorly characterized. We performed shotgun metagenomic sequencing of 41 skin samples collected from 18 patients at dry and moist anatomical sites before and after scabicidal treatment. In exploratory group-level comparisons, pretreatment moist-site samples had lower alpha diversity and higher bacterial and viral read-based burdens than post-treatment moist-site samples. Pretreatment dry and moist samples did not differ significantly in diversity, and Staphylococcus was the predominant genus. No genus- or species-level taxon or predicted pathway remained statistically significant after Benjamini–Hochberg false discovery rate correction at a threshold of 0.05. Nominal differences in predicted purine biosynthesis pathways were interpreted as exploratory observations. These findings provide a shotgun metagenomic characterization of the skin microbiome during active scabies and describe exploratory treatment-associated patterns that require confirmation in larger, paired longitudinal studies.