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If fungal cultures are required, the test is performed by a technologist who specializes in microbiology. [citation needed] Collection: Skin, nail, or hair samples are collected from the infected area on the patient. For skin samples, a scalpel or edge of a glass slide is used to gently scrape skin scales from the infected area.
Tinea incognita, also spelled tinea incognito, is a fungal infection of the skin that generally looks odd for a typical tinea infection. [1] [2] [a] The border of the skin lesion is usually blurred and it appears to have florid growth. [1] It generally occurs following the application of a steroid cream to what at first is thought to be eczema. [1]
Superficial scrapes of skin examined underneath a microscope may reveal the presence of a fungus.This is done by utilizing a diagnostic method called KOH test, [6] wherein the skin scrapings are placed on a slide and immersed on a dropful of potassium hydroxide solution to dissolve the keratin on the skin scrappings thus leaving fungal elements such as hyphae, septate or yeast cells viewable.
The disease patterns below identify the type of fungus that causes them only in the cases listed: Dermatophytosis Tinea pedis (athlete's foot): fungal infection of the feet; Tinea unguium: fungal infection of the fingernails and toenails, and the nail bed; Tinea corporis: fungal infection of the arms, legs, and trunk
The specimen (scraping from skin, nail, or hair) is embedded in the DTM culture medium. It is incubated at room temperature for 10 to 14 days. If the fungus is a dermatophyte, the medium will turn bright red. If the fungus is not a dermatophyte, no color change will be noted.
In dermatopathology, the Tzanck test, also Tzanck smear, is scraping of an ulcer base to look for Tzanck cells. It is sometimes also called the chickenpox skin test and the herpes skin test. It is a simple, low-cost, and rapid office based test. [1] Tzanck cells (acantholytic cells) are found in: Herpes simplex [2] Varicella and herpes zoster
Microscopically, sausage-shaped cells are mixed with hyphae-like structures. As the culture ages, segments begin to form. The cells divide by binary fission, rather than budding. The cells are not yeast cells, but rather arthroconidia. Culturing isn't the only method of diagnosis. A skin scraping can be prepared, and stained with Wright's stain.
A KOH test can also be used, where skin scraping of the affected skin may also be taken and prepared with potassium hydroxide (KOH) and visualized under a microscope to look for Malassezia or other microbiological cells. Additionally, a fungal culture of the affected skin may be taken to attempt to grow and identify the causative organism. [11]