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Evaluation Of The Efficacy Of Fluorescent Staining And Chicago Sky Blue Staining As Methods For Diagnosis Of Dermatophytosis In Hair And Nails

Authors Mourad B, Ismail M, Hawwam S, Msseha M, Hassan R

Received 14 May 2019

Accepted for publication 31 August 2019

Published 9 October 2019 Volume 2019:12 Pages 751—758

DOI https://doi.org/10.2147/CCID.S215661

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Nicola Ludin

Peer reviewer comments 2

Editor who approved publication: Dr Jeffrey Weinberg


Basma Mourad,1 Mayada Ismail,1 Soha Hawwam,1 Mina Msseha,2 Reham Hassan3

1Department of Dermatology and Venereology, Faculty of Medicine, Tanta University, Tanta, Egypt; 2Department of Microbiology and Immunology, Faculty of Medicine, Tanta University, Tanta, Egypt; 3Department of Dermatology and Venerelogy, Kafr Elsheikh General Hospital, Ministry of Health, Kafr Elsheikh, Egypt

Correspondence: Soha Hawwam
Faculty of Medicine, Tanta University, El Geish Street, Tanta 31111, Egypt
Tel +20 40 966540238619
Email soha_abdallah80@yahoo.com

Purpose: Dermatophytes are fungi that cause infections affecting hair, nail, and skin; in nails they cause onychomycosis, while in hair they lead to tinea capitis. Detection of dermatophytes using traditional methods, including potassium hydroxide (KOH) and culture on agar-based media leads to high rates of false-negative results. Here, we investigated more accurate diagnostic techniques, including Chicago sky blue staining and Calcofluor white fluorescent staining and compared them with traditional KOH and culture methods for the diagnosis of fungi causing onychomycosis and tinea capitis.
Patients and methods: This study was conducted using samples from 50 patients with dermatophytosis of the hair or nail. Samples were subjected to all the following laboratory investigations: KOH wet mount, culture on Sabouraud’s dextrose agar, Chicago sky blue staining, and Calcofluor white staining. The results of the new diagnostic techniques were compared with those of the traditional methods.
Results: Calcofluor white stain and Chicago sky blue stain for dermatophytosis of hair and nail are more specific and sensitive as compared to traditional diagnostic methods. KOH wet mount is simple, rapid, and inexpensive test but lacks color contrast and gave more false positive (artifacts) and false-negative results as compared to these new stain methods.
Conclusion: Chicago sky blue and Calcofluor white staining are excellent methods for diagnosis of fungal infections, including those that cannot be confirmed using conventional methods.

Keywords: Calcofluor white stain, dermatophytes, onychomycosis, tinea capitis

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