Content » Vol 100, 100-year theme: Cutaneous and genital infections (April)


A Hundred Years of Diagnosing Superficial Fungal Infections: Where Do We Come From, Where Are We Now and Where Would We Like To Go?

Yvonne Gräser, Ditte M.L. Saunte
DOI: 10.2340/00015555-3467


Superficial fungal infections have been known for hundreds of years. During the 20th century new diagnostic methods were developed and the taxonomy changed several times, which, unfortunately, resulted in many fungi having several names (synonyms). The taxonomy is important, as species-specific identification guides clinicians when choosing the most appropriate antifungal agent, and provides an indication of the source of infection (anthropophilic, zoophilic or geophilic). Traditional diagnostic tests (direct microscopy, culture and histopathology) are still widely used, but molecular-based methods, such as PCR, have many advantages, and increasingly supplement or replace conventional methods. Molecular-based methods provide detection of different genus/species spectra. This paper describes recent changes in dermatophyte taxonomy, and reviews the currently available diagnostics tools, focusing mainly on commercially available PCR test systems.


Superficial fungal infections (e.g. ringworm, thrush and fungal nail infections) have been known for hundreds of years. It is crucial to diagnose the fungus correctly, in order to choose the correct anti-fungal medication, and to provide information about the source of infection. Traditionally, diagnosis is based on microscopy, culture and histopathology of the specimen (hair, skin, nails). More recent molecular-based methods have been developed, but there is no standardization as to which fungi they detect. This paper presents an update on fungal taxonomy and describes the diagnostic tools available.

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