Rapid diagnosis of superficial fungal infections

Abstract

A 42-year-old woman presented with itching and a rash on the upper and lower back. She had been treated for eczema for 3 months with triamcinolone acetonide 0.1% cream without resolution of the rash. Physical examination revealed broad erythematous, scaling patches on the upper and lower back (figure I) and dry scaling on the feet in a “moccasin” distribution, with accentuation of scaling at the borders of the dorsum.

Microscopic examination of specimens from the back and feet using a potassium hydroxide (KOH) preparation revealed branching, septate hyphal elements diagnostic of dermatophyte fungi (figure 2). Griseofulvin ultra, microsize, 500 mg/day orally, was prescribed, and all signs and symptoms resolved in 1 month.