How useful is periodic acid-Schiff stain to detect fungi in biopsies from dermatoses of the palms and soles?


Journal

Journal of cutaneous pathology
ISSN: 1600-0560
Titre abrégé: J Cutan Pathol
Pays: United States
ID NLM: 0425124

Informations de publication

Date de publication:
Jun 2019
Historique:
received: 10 10 2018
revised: 20 02 2019
accepted: 25 02 2019
pubmed: 8 3 2019
medline: 5 9 2019
entrez: 8 3 2019
Statut: ppublish

Résumé

Periodic acid-Shiff (PAS) stain may help to diagnose fungal infection in biopsies from dermatoses of the palms and soles. It is questionable whether PAS stain should be used routinely or only when tinea is suspected clinically. A total of 195 consecutive punch biopsies of dermatoses from the palms (90) or soles (105) were stained with PAS, regardless of the clinical differential diagnosis. PAS stain showed fungi in the corneal layer of 6 (3%) of the 195 biopsies. Tinea was included in the differential diagnosis in 48 cases, of which 3 (6%) were PAS positive. PAS stain was also positive in 3 (2%) of 147 cases in which tinea was not suspected clinically. All 6 PAS-positive cases were detected in reaction patterns not readily classified as particular diagnostic entities: non-inflammatory keratoderma (2, 11%), chronic lichenified dermatitis (2, 6%), spongiotic psoriasiform dermatitis (1, 2%), and spongiotic dermatitis (1, 4%). There is a low concordance rate between the clinical suspicion and the actual demonstration of fungi by PAS stain in dermatoses of the palms and soles. Routine PAS stains in non-suspected cases have a relatively low yield, which may be improved by limiting the PAS stain to reaction patterns not readily classified as particular diagnostic entities.

Sections du résumé

BACKGROUND BACKGROUND
Periodic acid-Shiff (PAS) stain may help to diagnose fungal infection in biopsies from dermatoses of the palms and soles. It is questionable whether PAS stain should be used routinely or only when tinea is suspected clinically.
METHODS METHODS
A total of 195 consecutive punch biopsies of dermatoses from the palms (90) or soles (105) were stained with PAS, regardless of the clinical differential diagnosis.
RESULTS RESULTS
PAS stain showed fungi in the corneal layer of 6 (3%) of the 195 biopsies. Tinea was included in the differential diagnosis in 48 cases, of which 3 (6%) were PAS positive. PAS stain was also positive in 3 (2%) of 147 cases in which tinea was not suspected clinically. All 6 PAS-positive cases were detected in reaction patterns not readily classified as particular diagnostic entities: non-inflammatory keratoderma (2, 11%), chronic lichenified dermatitis (2, 6%), spongiotic psoriasiform dermatitis (1, 2%), and spongiotic dermatitis (1, 4%).
CONCLUSIONS CONCLUSIONS
There is a low concordance rate between the clinical suspicion and the actual demonstration of fungi by PAS stain in dermatoses of the palms and soles. Routine PAS stains in non-suspected cases have a relatively low yield, which may be improved by limiting the PAS stain to reaction patterns not readily classified as particular diagnostic entities.

Identifiants

pubmed: 30843246
doi: 10.1111/cup.13451
doi:

Substances chimiques

Periodic Acid 10450-60-9

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

418-420

Informations de copyright

© 2019 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Auteurs

Hiba Zaaroura (H)

Department of Dermatology, Rambam Health Care Campus and the Bruce Rappaport Faculty of Medicine, Haifa, Israel.

Reuven Bergman (R)

Department of Dermatology, Rambam Health Care Campus and the Bruce Rappaport Faculty of Medicine, Haifa, Israel.
Department of Pathology, Rambam Health Care Campus and the Bruce Rappaport Faculty of Medicine, Haifa, Israel.

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Classifications MeSH