title: Comparative study of efficacy, rapidity of detection, and cost-effectiveness of potassium hydroxide, calcofluor white, and Chicago sky blue stains in the diagnosis of dermatophytoses.
abstract: BACKGROUND
  The diagnosis of superficial mycosis such as dermatophytosis is often done clinically. However, in difficult cases, a rapid test with high sensitivity and specificity helps in the immediate confirmation and administration of treatment.
  
  
  METHODS
  The efficacy, rapidity of detection, and cost-effectiveness of KOH preparation, calcofluor white (CW) stain, and Chicago sky blue (CSB) stain in the identification of fungal elements were assessed in patients with dermatophytoses attending the dermatology clinic of a tertiary care hospital. All three tests were performed on each sample collected from 73 patients according to standard procedure. The slides were examined after 5 and 30 minutes in × 10 and × 40 magnifications. The sensitivity and specificity of CW and CSB at 5 and 30 minutes were calculated using KOH preparation as the standard test.
  
  
  RESULTS
  CSB stain showed highest positivity (94.5%) within 5 minutes when compared to KOH (75.3%) and CW (83.5%). After 30 minutes, positivity increased in KOH (84.9%) and CW stains (89%), but it remained the same in CSB stain. Both CW and CSB stains when compared to 10% KOH are equally sensitive (100%), but CW was more specific (72.7%), particularly at 30 minutes. When cost of performing tests on 100 specimens is considered, KOH, CW, and CSB stains cost Rs 5, 100, and 15, respectively.
  
  
  CONCLUSIONS
  CSB stain is a better stain for rapid diagnosis of dermatophytoses because of ease of performance, rapidity of detection, better appreciation of morphology of fungal elements, and cost effectiveness.
authors: DM Wayanad Institute of Medical Sciences, Wayanad, Kerala, India.
authors: R
authors: R
authors: Prakash
authors: Venereology and Leprosy, Sri Siddhartha Medical College, Agalakote, Tumkur, Karnataka, India.
authors: Hosakere Veerappa
authors: HV
authors: Prashanth
authors: Venereology and Leprosy, Sri Siddhartha Medical College, Agalakote, Tumkur, Karnataka, India.
authors: Shivanna
authors: S
authors: Ragunatha
authors: Venereology and Leprosy, Sri Siddhartha Medical College, Agalakote, Tumkur, Karnataka, India.
authors: Meenakshi
authors: M
authors: Kapoor
authors: Wayanad Institute of Medical Sciences, Wayanad, Kerala, India.
authors: T K
authors: TK
authors: Anitha
authors: Sri Siddhartha Medical College, Tumkur, Karnataka, India.
authors: Veena
authors: V
authors: Krishnamurthy
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001557:Benzenesulfonates / Q000191:economics; D002648:Child; D002675:Child, Preschool; D004396:Coloring Agents / Q000191:economics; D003362:Cost-Benefit Analysis; D005260:Female; D006801:Humans; D006878:Hydroxides / Q000191:economics; D008297:Male; D008853:Microscopy; D008875:Middle Aged; D017680:Potassium Compounds / Q000191:economics; D011237:Predictive Value of Tests; D013194:Staining and Labeling / Q000191:economics / Q000379:methods*; D013997:Time Factors; D014005:Tinea / Q000000981:diagnostic imaging*; D014343:Trypan Blue / Q000191:economics; D055815:Young Adult
chemical_list: D001557:Benzenesulfonates; D004396:Coloring Agents; D006878:Hydroxides; D017680:Potassium Compounds; C009000:pontamine sky blue; C007061:C.I. Fluorescent Brightening Agent 28; D014343:Trypan Blue; C029943:potassium hydroxide