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DERMOSCOPY – The new non-microbiological diagnostic tool for mycotic infections
Joint Event on International Conference on Pathology and Infectious Diseases & 3rd International Conference on Pathology and Oncology Research
November 11-12, 2019 | Singapore
Sidharth Sonthalia
SKINNOCENCE: The Skin Clinic and Research Centre, India
Scientific Tracks Abstracts : J Infectious Disease Med Microbiol
Abstract:
Background: The rampant use of over-the counter steroids
for tinea has resulted in the epidemic of tinea incognita
leading to the epidemic of antifungal therapeutic failures in
South Asian countries. Intermittent or prolonged use of oral/
topical corticosteroids in cutaneous fungal infections not only
renders treatment difficult, but also jeopardizes clinical as well
as laboratory diagnosis by standard KOH smear and fungal
culture methods, since the scaling (that contains the fungi)
is dramatically suppressed. DERMOSCOPY is a relatively new
non-invasive imaging technique that has till now been used by
skin specialists for discerning benign moles from melanomas.
However, in this lecture, I shall demonstrate and explain the
innovative repurposing of Dermoscopy by my team and me to
serve as a dependable tool for prompt diagnosis of cutaneous
mycotic infections.
Dermoscopy in diagnosis, selection of choice of treatment
and follow-up in patients with steroid-modified tinea/
dermatophytosis:
o Onychoscopy [Dermoscopy of the Nail Unit for diagnosis of
Onychomycosis]
• Onycholysis with jagged proximal margin
• Aurora borealis pattern (longitudinal striae of different
colors)
• Ruin pattern (distal pulverization of nail plate)
• Fungal melanonychia
o Trichoscopy [Dermoscopy of the Scalp & Hair for diagnosis of
Tinea Capitis]
• Comma or C-shaped hair Cork screw hair or coiled hair
Broken/ zig-zag/ bended/ angulated/ deformable hair
• Black dots, Morse-code hair and translucent hair
• More specific for ectothrix infections – morse code hair,
endothrix infection – comma/ cork-screw hair.
Dermoscopy OF NON-GLABROUS skin for diagnosing Tinea
corporis/cruris INCOGNITO [when KOH and culture are difficult
due to suppression of scaling]
o Tinea of vellus hair – perifollocular scaling, translucent hair,
bended hair, morse-code hair, corkscrew and comma-shaped
hair, brown dots with whitish halo – indication for systemic
antifungal treatment and aids in deciding treatment duration.
• Dermoscopy OF GLABROUS skin for diagnosing Tinea of palms
and soles
• Tinea pedis/ mannum – localization of scales to palmar and
plantar creases.
Conclusion: Thus, in this lecture, I shall share the past 10-years of
experience of my team in repurposing DERMOSCOPY as a tool
for diagnosis of fungal infections, especially when KOH/culture
are not possible or non-diagnostic.
Biography:
Sidharth Sonthalia is a Senior Consultant Dermatologist & Medical Director, SKINNOCENCE: The Skin Clinic & Research Center, Gurugram, India. He devotes his time equally to patients, active research (translational/clinical) and education of other Dermatologists and allied Specialists in novel and controversial subjects like Dermoscopy, Dermatopathology, Management of Resistant Fungal Infections, Psychodermatology PCOS etc., by organizing focused congresses and International Summits under the aegis of his initiative DermaSource India,. He has delivered more than 80 lectures as invited Guest Faculty at various International conferences organized by ASPCR, ICD, IPCC, CCD, WCD, WDC and DERMACONS. He is serving as the Founding Chair of the South Asian Alliance against Cutaneous Mycosis [SAARCUM], Secretary General of Asian Society of Pigment Cell research [ASPCR], Chief Founder & Secretary General of the Indian Society of Dermoscopy, Onychoscopy & Trichoscopy [ISODOT], He is a founding cochair of the Afro-Asian Dermoscopy Group [AADG].
E-mail: drsidharthsonthalia@gmail.com
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