Touch Biopsy: A Simple and Rapid Method for the Diagnosis of Systemic Mycoses with Skin Dissemination in HIV-Infected Patients

Cutaneous dissemination; Rapid diagnosis; Systemic fungal infection

Fungi are known to be one of the types of microorganisms responsible for fatal opportunistic infections in HIV-infected patients (Lortholary et al., 1999; Vanittanakom et al., 2006; Bicanic et al., 2008). The dissemination of systemic fungal infections to the skin is common in HIV-infected patients, and laboratory investigations are required to establish timely diagnosis (Lortholary et al., 1999; Dhar et al., 2006; Dinato et al., 2006).

Systemic fungal infection is very difficult to diagnose because the fungus infects internal organs and  thus biopsy is required to obtain clinical materials for laboratoryinvestigations (Azar and Hage, 2017; Sanguinetti et al., 2019). Dissemination to the skin is a blessing in disguise because the collection of clinical materials becomes much easier.

In our laboratory, sample collection for cutaneous mycoses is generally completed using skin scraping for microscopic wet slide analysis and culture. However, this approach has several limitations. For example, fungi such as Histoplasma do not occur in superficial skin scales but in leucocytes, which may not be observable in KOH preservation (Kauffman, 2007), although KOH is very good in plasma electrolysis (Saksono et al., 2012). Culturing is a diagnostic effort that is always carried out in mycological investigations. Culturing can be used to isolate the causative fungi, but unfortunately, this method is time-consuming. Meanwhile, patients with systemic mycoses require immediate diagnosis so that the right drug can be given promptly.

    Touch biopsy is a simple, rapid method of diagnosing systemic mycosis with cutaneous dissemination. This method provides fast results, allowing for immediate anti-fungal treatment.

    RW received a research grant from Dana Ilmu Pengetahuan Indonesia/ Lembaga Pengelolaan Dana Pendidikan (DIPI/LPDP) with contract number MR/P017622/1, year 2017–2020.

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