CLINICAL ISSUES :: MOLECULAR DIAGNOSTICS FOR DERMATOMYCOSIS
culture. They showed that molecular methods were able to identify a fungal pathogen in 65% of these samples, empha- sizing the importance of molecular testing for the diagnosis of dermatophyte and non-dermatophyte dermatomycosis when a culture yields a negative or contaminated result.26
Conclusion
Although dermatomycosis is the most prevalent fungal infection worldwide,1
it remains undertreated.4 While dermatomycosis
generally has a low mortality rate and mild severity in healthy individuals, invasive dermatomycosis can cause severe disease in elderly and immunocompromised patients.5-7
Fungal culture and
microscopy are commonly used to diagnose dermatomycosis, but methodological limitations such as long incubation time, limited sensitivity, and inability to identify fungal species can prevent patients from receiving timely and accurate diagnoses and treatments. However, the use of molecular methods facilitates rapid, species-specific determination of causative pathogens. In addition, the combination of molecular methods and conven- tional diagnostics leads to improved sensitivity for detection of dermatomycosis. Notably, the use of PCR-based DNA microarray methodology combined with direct microscopy results in 100% sensitivity and rapid species identification, thereby enabling patients to receive prompt and accurate treatment.
REFERENCES
1. Havlickova B, Czaika VA, Friedrich M. Epidemiological trends in skin mycoses worldwide. Mycoses. 2008;51 Suppl 4:2-15. doi:10.1111/j.1439-0507.2008.01606.x.
2. Nenoff P, Kruger C, Schaller J, Ginter-Hansel- mayer G, Schulte-Beerbuhl R, Tietz HJ. Mycol- ogy - an update part 2: dermatomycoses: clinical picture and diagnostics. J Dtsch Dermatol Ges. 2014;12(9):749-777. doi:10.1111/ddg.12420.
3. Weitzman I, Summerbell RC. The dermato- phytes. Clin Microbiol Rev. 1995;8(2):240-259. doi:10.1128/CMR.8.2.240.
4. Lipner SR, Joseph WS, Vlahovic TC, et al. Ther- apeutic Recommendations for the Treatment of Toenail Onychomycosis in the US. J Drugs Derma- tol. 2021;20(10):1076-1084. doi:10.36849/JDD.6291.
5. Achterman RR, White TC. A foot in the door for dermatophyte research. PLoS Pathog. 2012;8(3):e1002564. doi:10.1371/journal.ppat.1002564.
6. Wang R, Huang C, Zhang Y, Li R. Invasive derma- tophyte infection: A systematic review. Mycoses. 2021;64(4):340-348. doi:10.1111/myc.13212.
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7. Zhu A, Zembower T, Qi C. Molecular detection, not extended culture incubation, contributes to diagnosis of fungal infection. BMC Infect Dis. 2021;21(1):1159. doi:10.1186/s12879-021-06838-6.
8. Yadgar RJ, Bhatia N, Friedman A. Cutaneous fungal infections are commonly misdiagnosed: A survey-based study. J Am Acad Dermatol. 2017;76(3):562-563. doi:10.1016/j.jaad.2016.09.041.
9. Heckler I, Sabalza M, Bojmehrani A, Ven- kataraman I, Thompson C. The need for fast and accurate detection of dermatomycosis. Med Mycol. 2023;61(5). doi:10.1093/mmy/myad037.
10. Petrucelli MF, Abreu MH, Cantelli BAM, et al. Epidemiology and Diagnostic Perspectives of Dermatophytoses. J Fungi (Basel). 2020;6(4). doi:10.3390/jof6040310.
11. Kidd SE, Weldhagen G. Diagnosis of dermato- phytes: from microscopy to direct PCR. Microbiol Aust. 2022;43(1):9-13. doi:10.1071/ma22005.
12. Abdelrahman T LBV, Waller J, Noacco G, Candolfi E. Dermatomycosis: comparison of the performance of calcofluor and potassium hydroxide 30% for the direct examination of skin scrapings and nails. J Mycol Med. 2006;16(2):87-91. doi:10.1016/
j.mycmed.2006.03.003.
References 13-30 online @
https://mlo-online.com/53068716
Jackie Weiss, PhD is the Scientific Affairs Liaison at EUROIMMUN US Her role includes working with key opinion leaders on scientific collaborations, scientific writing, and supporting the team with commercial activities.
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