Cutaneous Candidiasis Workup

Updated: Jan 17, 2020
  • Author: Richard Harold "Hal" Flowers, IV, MD; Chief Editor: Dirk M Elston, MD  more...
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Workup

Laboratory Studies

KOH preparation is the easiest and most cost-effective method for diagnosing cutaneous candidiasis, but its use is not sufficient in the absence of other supporting clinical evidence.

Culture from an intact pustule, skin biopsy tissue, or desquamated skin can help to support the diagnosis.

Microscopic examination of skin scrapings prepared with calcofluor white stain is a simple way of detecting yeasts and pseudohyphae of C albicans. C albicans binds nonspecifically to polysaccharides found in fungal cell walls and produces a distinct bright color in a pattern characteristic for the organism when viewed under a fluorescence microscope.

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Histologic Findings

A skin biopsy specimen stained with a periodic acid-Schiff stain reveals nonseptated hyphae. The presence of nonseptated hyphae allows cutaneous candidiasis to be distinguished from tinea. Classically, neutrophils are seen in the stratum corneum. [57] In the subsequent epidermis, focal spongiosis and mild acanthosis may be noted. [57]

Of all the types of Candida, the electron microscope shows that C albicans is the most confluent in its adherence to the skin. [58]

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