Histopathological study of cutaneous and soft tissue fungal infections

Kaliyamoorthy, Siva; Subramanian, Sowmya

doi:10.18203/2320-6012.ijrms20161736

Cited by 2 publications

(2 citation statements)

References 2 publications

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“…The extent of spread of the infection to the hair follicle or other appendageal structures can be determined by histopathology along with special stains, making it an essential diagnostic tool for the assessment and management in chronic and recalcitrant dermatophytosis. [ 11 12 ] In view of the above alarming and rapidly changing trends, the present study was undertaken to determine the clinical patterns, mycological profile, and histopathological changes including invasion of hair follicle in cases of recurrent dermatophytosis.…”

Section: Discussionmentioning

confidence: 99%

A Clinico-Mycological and Histopathological Study of Recurrent Dermatophytosis

Gopal,

Turpati

et al. 2023

Indian Dermatology Online Journal

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Background: A few recent studies have shown fungal elements within the hair follicle epithelium, which may act as a reservoir and responsible for recurrent dermatophytosis. Objectives: To assess the clinical patterns, mycological profile, and histopathology of recurrent dermatophytosis and to determine the prevalence of fungal hyphae in the hair follicle epithelium and other appendages. Materials and Methods: One hundred and fifty clinically diagnosed cases of recurrent dermatophytic infection were included. Skin samples were taken for direct microscopy, fungal culture, and histopathological analysis. Haematoxylin and eosin and special staining with periodic acid Schiff (PAS) and Gomori's methenamine silver (GMS) were performed to detect the fungal hyphae in the skin and hair follicle epithelium. Results: The most common clinical pattern observed was tinea corporis et cruris in 64 patients (42.66%). On direct microscopy and fungal culture, positive results were obtained in 116 cases (77.33%) and 78 (52%) cases, respectively. Presence of fungal hyphae in the stratum corneum, hair follicle, and acrosyringium was seen in 107 patients (71.33%), 47 patients (31.33%), and five patients (3.33%), respectively. Out of the 52 cases with hair follicle and eccrine gland involvement, history of fixed drug combinations (FDC) cream use was present in 42 cases (80.76%) and absent in ten cases (19.24%) (P = 0.000062). Limitations: Skin samples were taken only from a single skin lesion. Higher incidence of follicular invasion may have been detected if multiple biopsy samples were taken. Conclusion: Hair follicle/eccrine sweat gland involvement was observed in nearly one-third of the patients, which may act as a reservoir and may be responsible for recurrence and chronicity. Histopathology should be considered as an important adjuvant tool in recurrent dermatophytosis to establish the extent of the infection, which guides the further management.

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Section: Discussionmentioning

confidence: 99%

A Clinico-Mycological and Histopathological Study of Recurrent Dermatophytosis

Gopal,

Turpati

et al. 2023

Indian Dermatology Online Journal

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“…This can be correlated with the study by Kaliyamoorthy and Srinivasan, who observed various such histomorphological changes. [12] Furthermore, a study by Gocev and Damevska[9] reported that majority cases of SFIs may present with histomorphological changes such as perivascular infiltrate, hyperkeratosis, acanthosis, and dermal edema, and also, spongiotic, psoriasiform, vasculopathic, and folliculitis/perifolliculitis histopathological reaction patterns can be observed. The observations of histomorphological changes in a study conducted by Al-Amiri et al .…”

Section: Discussionmentioning

confidence: 99%

Histopathology of hair follicle epithelium in patients of recurrent and recalcitrant dermatophytosis: A diagnostic cross-sectional study

et al. 2019

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Context: Recurrent and recalcitrant dermatophytosis is a major evolving health problem in India. Histopathology is important in the diagnosis of recurrent and resistant cases, as it is postulated that hair follicle epithelium is affected, acting as the reservoir leading to recurrence and recalcitrance. Aims: This study aims to study histopathology of hair follicle epithelium in patients of recurrent and recalcitrant dermatophytosis. Settings and Design: A diagnostic cross-sectional study was performed at tertiary care hospital and referral center in central India. Materials and Methods: A 3 mm-sized punch skin biopsy was taken from 108 patients of recurrent or recalcitrant dermatophytosis involving hair follicles. Sections were stained by hematoxylin and eosin (H and E) stain in these patients followed by special stains such as periodic acid–Schiff (PAS) stain and Gomori methenamine silver (GMS) stain in 78 individuals where hair follicle was seen on H and E stain. Results: In H and E stain, surface epidermis fungus was observed in 57/108 patients (52.7%). In hair follicle-positive sections (78), surface fungus was seen in 52.6% with H and E stain, 84.6% with PAS stain, and 91% with GMS stain. H and E was 62.12% sensitive and 100% specific to diagnose fungus when compared with PAS stain and 57.7% sensitive and 100% specific when compared with GMS stain. PAS was 91.5% sensitive and 85.7% specific when compared with GMS stain. Ectothrix infection was the most common form of hair infection observed in 87.2% cases with GMS stain. Simultaneous presence of fungus in hair follicle and stratum corneum was observed in 87.3% of patients. Conclusion: Majority of patients showed affection of hair follicles by dermatophytes in clinically chronic, recurrent, and recalcitrant dermatophytic infections. GMS stain is the acceptable gold standard for detection of fungal elements.

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Histopathological study of cutaneous and soft tissue fungal infections

Cited by 2 publications

References 2 publications

A Clinico-Mycological and Histopathological Study of Recurrent Dermatophytosis

A Clinico-Mycological and Histopathological Study of Recurrent Dermatophytosis

Histopathology of hair follicle epithelium in patients of recurrent and recalcitrant dermatophytosis: A diagnostic cross-sectional study

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