Tinea pedis in a child: How reflectance confocal microscopy can help in diagnosis of dermatophytosis

Cantelli, Mariateresa; Capasso, Gianmarco; Costanzo, Luca; Fabbrocini, Gabriella; Gallo, Lucia

doi:10.1111/pde.14487

Cited by 3 publications

(9 citation statements)

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“…RCM has been described in paediatric patients in isolated case reports and case series, as for xanthogranuloma, 5 mastocitosis 6 and infectious conditions such as dermatophytosis, 7 scabies 8 and molluscum contagiosum 9 . Moscarella et al 10 described the use of RCM for the assessment of a solitary red nodule, and even if the latter study was not specific for the paediatric population, it included common conditions seen in this population, such as pyogenic granuloma, Spitz nevus and dermatofibroma.…”

Section: Discussionmentioning

confidence: 99%

“…RCM also finds its use for infectious conditions that are sometimes even more prevalent in children than adults, such as warts and dermatophytosis. The use of RCM has been described for dermatophytosis by Cantelli et al 2020, 7 and the direct visualisation of bright linear structures in the stratum corneum, corresponding to fungal hyphae, can be a helpful tool for diagnosis.…”

Section: Discussionmentioning

confidence: 99%

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Reflectance confocal microscopy in paediatric patients: Applications and limits

Scharf

Brizzi

Licata

et al. 2022

Experimental Dermatology

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Reflectance confocal microscopy in paediatric patients: Applications and limits

Scharf

Brizzi

Licata

et al. 2022

Experimental Dermatology

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“…KOH scraping yields limited information about the viability of the isolated fungal spores and hyphae. If antifungal therapy has begun before KOH scraping, false negatives can be reported [ 1 ]. In addition, sampling error, excess scale in sample, and inadequate KOH hydrolysis may lead to false negative results.…”

Section: Introductionmentioning

confidence: 99%

“…Reflectance confocal microscopy (RCM) is a non-invasive imaging tool that visualizes skin and its appendages at near-histologic resolution (lateral resolution of 0.5 to 1 μm) [ 1 ]. RCM uses a low-power 830 nm diode laser to illuminate the targeted area of tissue.…”

Section: Introductionmentioning

confidence: 99%

“…RCM uses a low-power 830 nm diode laser to illuminate the targeted area of tissue. RCM produces grayscale horizontal images that can be taken at levels ranging from the stratum corneum to the superficial papillary dermis [ 1 ], corresponding to a depth of approximately 150–200 µm. An automated program allows the capture of a series of mosaics, which consist of single images 0.5 × 0.5 mm square, captured in a serpentine motion and then “stitched” together like a quilt to create a single, full-resolution image that is up to 8 × 8 mm square in a horizontal plane.…”

Section: Introductionmentioning

confidence: 99%

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Applications of Reflectance Confocal Microscopy in the Diagnosis of Fungal Infections: A Systematic Review

Khan

Farabi

Navarrete‐Dechent

et al. 2022

JoF

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Cutaneous and adnexal fungal infections are typically diagnosed with potassium hydroxide (KOH) skin scrapings, fungal cultures, and Periodic acid-Schiff (PAS) biopsy staining. All three current methods of fungal diagnosis require sample processing and turnover time which leads to a delay in diagnosis. Reflectance confocal microscopy (RCM) is a non-invasive, in vivo skin imaging technology that provides real-time dermatologic diagnoses. We present an updated systematic review of the applications of RCM in diagnosing fungal infections in an effort to explore the utility of RCM as an adjunct clinical tool in detecting cutaneous and adnexal fungi We systematically searched the MEDLINE (via PubMed) for studies published from January 2000 to October 2022 that described the utility of RCM in the setting of fungal infections. Of the 25 studies that met the inclusion criteria, 202 patients were included. The following information on the application of RCM in the setting of fungal infections was extracted from each study, if reported: study type, year published, number of patients included, diagnosis/diagnostic methods, and RCM description. Concordant within all included studies, fungal infections presented on RCM as bright, linear, branching, filamentous structures at the level of stratum corneum. A limitation of this review is that 11 of 25 studies were case reports (n = 1). Larger scale studies should be conducted to explore the utility of RCM in diagnosing fungal infections and to enrich the RCM descriptions of specific fungal conditions.

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Tinea pedis: an updated review

Leung¹,

Barankin²,

Lam³

et al. 2023

DIC

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Background Tinea pedis is one of the most common superficial fungal infections of the skin, with various clinical manifestations. This review aims to familiarize physicians with the clinical features, diagnosis and management of tinea pedis. Methods A search was conducted in April 2023 in PubMed Clinical Queries using the key terms ‘tinea pedis’ OR ‘athlete’s foot’. The search strategy included all clinical trials, observational studies and reviews published in English within the past 10 years. Results Tinea pedis is most often caused by Trichophyton rubrum and Trichophyton interdigitale . It is estimated that approximately 3% of the world population have tinea pedis. The prevalence is higher in adolescents and adults than in children. The peak age incidence is between 16 and 45 years of age. Tinea pedis is more common amongst males than females. Transmission amongst family members is the most common route, and transmission can also occur through indirect contact with contaminated belongings of the affected patient. Three main clinical forms of tinea pedis are recognized: interdigital, hyperkeratotic (moccasin-type) and vesiculobullous (inflammatory). The accuracy of clinical diagnosis of tinea pedis is low. A KOH wet-mount examination of skin scrapings of the active border of the lesion is recommended as a point-of-care testing. The diagnosis can be confirmed, if necessary, by fungal culture or culture-independent molecular tools of skin scrapings. Superficial or localized tinea pedis usually responds to topical antifungal therapy. Oral antifungal therapy should be reserved for severe disease, failed topical antifungal therapy, concomitant presence of onychomycosis or in immunocompromised patients. Conclusion Topical antifungal therapy (once to twice daily for 1–6 weeks) is the mainstay of treatment for superficial or localized tinea pedis. Examples of topical antifungal agents include allylamines (e.g. terbinafine), azoles (e.g. ketoconazole), benzylamine, ciclopirox, tolnaftate and amorolfine. Oral antifungal agents used for the treatment of tinea pedis include terbinafine, itraconazole and fluconazole. Combined therapy with topical and oral antifungals may increase the cure rate. The prognosis is good with appropriate antifungal treatment. Untreated, the lesions may persist and progress.

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Tinea pedis in a child: How reflectance confocal microscopy can help in diagnosis of dermatophytosis

Cited by 3 publications

References 5 publications

Reflectance confocal microscopy in paediatric patients: Applications and limits

Reflectance confocal microscopy in paediatric patients: Applications and limits

Applications of Reflectance Confocal Microscopy in the Diagnosis of Fungal Infections: A Systematic Review

Tinea pedis: an updated review

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