Evaluation of skin biopsies for fungal infections: role of routine fungal staining

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Abstract

Background

The diagnosis of cutaneous fungal infection is usually made on clinical examination of the lesion and direct microscopic examination of skin scrapings with potassium hydroxide. Histopathological examination is rarely required to confirm dermatophytic infections. There is often a discord between the clinical and histopathological findings and many times clinical appearance can have a poor histopathological correlation.

Methods

This retrospective study was carried out on all skin biopsies received in a period of 1 year. The clinical details of all cases were retrieved and slides were reviewed. Routine fungal staining periodic acid-Schiff (PAS) stain was performed in all cases.

Results

Of 403 skin biopsies received in 1 year, material for further staining was available in 338. On re-examining the slides stained with PAS stain, fungi were identified in 34 cases (10%), of which fungal infection had been suspected clinically in five cases.

Conclusions

Use of routine stains like PAS can help to reach a correct diagnosis and initiate appropriate treatment. Fungal staining should be done in skin biopsies with non-specific clinical details and microscopic findings for best patient management.

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