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Fungal skin infection - scalp - Management
Basis for recommendation
Confirming the diagnosis
- The recommendation that microscopy and culture should be used to confirm the diagnosis, and the advice on how to take samples is based on expert opinion from the Health Protection Agency [HPA, 2007; HPA, 2009].
- Microscopy of skin scrapings and hair shafts can confirm infection. However, false negatives are common even with experienced examiners. Fungal culture is more sensitive than microscopy, allows identification of the causative organism, and may guide treatment [Higgins et al, 2000; Andrews and Burns, 2008].
Using a cytobrush
- The recommendation to use a cytobrush is based on a prospective, observational, comparative study of 178 people. Of the people studied, mycologically proven tinea capitis was detected using skin scrapings in 115/135 (85.1%), compared with 132/135 (97.7%) with the cytobrush method (p = 0.025) [Bonifaz et al, 2007].
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