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Rapid detection of dermatophytes from skin and hair
Jaya Garg1, Ragini Tilak, Atul Garg
1Department of Microbiology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India. jaya_bhu@rediffmail.com
Background:
Dermatophytes are a group of closely related keratinophilic fungi that can invade keratinized humans and animals tissues such as skin, hair and nails causing dermatophytosis. They are an important cause of superficial fungal infection.
Findings:
Conventional methods like potassium hydroxide (KOH) microscopy and fungal culture lacks the ability to make an early and specific diagnosis. In this study we have evaluated nested Polymerase chain reaction (PCR) using primers targeting dermatophyte specific sequence of chitin synthase 1 (CHS1) gene and compared with conventional test. A total of 155 patients clinically suspected with dermatophytosis were included in the study. Of which 105 specimens were skin scrapings and 50 were hair. KOH microscopy, fungal culture and first round and nested PCR were done on clinical specimens, and results compared. Nested PCR for dermatophytes was positive in 83.8% specimens, followed by KOH microscopy (70%), first round PCR (50.8) and fungal culture (25.8).
Conclusion:
Results indicate that nested PCR may be considered as gold standard for the diagnosis of dermatophytosis and can aid the clinician in initiating prompt and appropriate antifungal therapy.
Insights
Nested Polymerase chain reaction (PCR) offers a more accurate and early diagnosis for dermatophytosis compared to traditional methods. This fungal infection diagnostic approach aids clinicians in timely antifungal treatment.
Area of Science:
- Medical Mycology
- Molecular Diagnostics
- Dermatology
Background:
- Dermatophytes are keratinophilic fungi causing superficial infections like dermatophytosis in humans and animals.
- Infections affect keratinized tissues including skin, hair, and nails.
- Early and specific diagnosis of dermatophytosis is crucial for effective treatment.
Purpose of the Study:
- To evaluate the efficacy of nested Polymerase chain reaction (PCR) for diagnosing dermatophytosis.
- To compare nested PCR with conventional diagnostic methods: potassium hydroxide (KOH) microscopy and fungal culture.
- To determine if nested PCR can serve as a gold standard for dermatophytosis diagnosis.
Main Methods:
- A total of 155 patients with suspected dermatophytosis were enrolled.
- Clinical specimens (105 skin scrapings, 50 hair samples) were analyzed.
- Nested PCR targeting the chitin synthase 1 (CHS1) gene was performed and compared with KOH microscopy and fungal culture.
Main Results:
- Nested PCR demonstrated the highest positivity rate at 83.8% for dermatophyte detection.
- Conventional methods showed lower detection rates: KOH microscopy (70%), first-round PCR (50.8%), and fungal culture (25.8%).
- Nested PCR significantly outperformed conventional tests in sensitivity and specificity.
Conclusions:
- Nested PCR is a highly sensitive and specific method for diagnosing dermatophytosis.
- It can be considered a gold standard, enabling earlier and more accurate diagnosis.
- Prompt diagnosis facilitates timely and appropriate antifungal therapy for patients.
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