Clinical, Dermoscopic, and Mycological Evaluations of Resistant Dermatophytosis

Trial design

Treatments tested in this trial

• Direct microscopic KOH examination

  Diagnostic test Diagnostic testA test used to detect or assess a condition, such as imaging or a laboratory test.

  Clinicians typically will use a scalpel or curette to scrape the lesion's edge, particularly the most recent lesion where fungal elements are most likely to be found . Specimens will be collected after proper skin cleansing with alcohol 70 % a and sealed in sterile dry Petri dishes (Gold and Lockhart, 2025). Samples will be labeled with the patient's name, age, sex, date of collection, and site of infection and subsequently brought to the laboratory for mycological examination . The samples collected will be screened for the presence of fungal elements using a 10% KOH with 40% Dimethyle sulphoxide (DMSO) mount mixed in equal proportion

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• Culture:

  Diagnostic test Diagnostic testA test used to detect or assess a condition, such as imaging or a laboratory test.

  After a direct microscopic examination, skin scraping specimens will be inoculated in a Petri dish: containing sabrouds Dextrose Agar added to it (chloramphenicol ) acts as a broad spectrum antibiotic, which inhibits a wide range of gram-positive and gram-negative bacteria) and cycloheximide (to inhibit saprophytic fungi) and other Petri dish containing Dermasel agar base, supplemented with chloramphenicol and cycloheximide. Cultures will be incubated aerobically at room temperature (25°C) for up to 4 weeks. Positive cultures will be examined both macroscopically (color of the surface and reverse, topography, and texture) and microscopically (after staining of growth colony with lactophenol cotton blue stain or methylene blue stain) to determine two types of conidia for species identification. In the absence of any growth after 4 weeks, the culture will be considered negative

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• Antifungal susceptibility testing:

  Diagnostic test Diagnostic testA test used to detect or assess a condition, such as imaging or a laboratory test.

  Agar Based Disc Diffusion (ABDD) antifungal susceptibility testing will be performed using eight antifungal agents: Clotrimazole, Miconazole, Fluconazole, Ketoconazole, Terbinafine, Voriconazole, Itraconazole and Griseofulvin on Mueller-Hinton medium. When growth occurs, the size of the zones of inhibition around the disks will be measured and recorded. Criteria of susceptibility and resistance of antifungal agents will be measured according to clinical and laboratory standards institutes (CLSI

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• Conventional PCR:

  Diagnostic test Diagnostic testA test used to detect or assess a condition, such as imaging or a laboratory test.

  1. Extraction of fungal nucleic acid: will be done using commercial kits. 2. Amplification and detection of different species using species- specific primers by conventional PCR.