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Tinctorial Properties of Zygomycosis in Cutaneous Biopsy Specimens
Author(s) -
Rubin A.,
Silvers D.
Publication year - 2005
Publication title -
journal of cutaneous pathology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.597
H-Index - 75
eISSN - 1600-0560
pISSN - 0303-6987
DOI - 10.1111/j.0303-6987.2005.320gh.x
Subject(s) - zygomycosis , staining , dermatopathology , pathology , h&e stain , grocott's methenamine silver stain , medicine , periodic acid–schiff stain , biopsy , dermatology , amphotericin b , antifungal
It is a little known fact that the organisms causing Zygomycosis are often better visualized with routine Hematoxylin and Eosin (H and E) staining than Periodic Acid Schiff (PAS) staining. Experienced dermatopathologists, when evaluating histologic samples suspected of harboring deep fungal infection often rely more heavily on PAS staining to detect fungi. The diagnosis of Zygomycosis may be delayed or missed entirely if sufficient attention is not devoted to the H and E stained specimen. A review of multiple dermatopathology textbooks shows there is no universal agreement on the usefulness of routine H and E staining versus use of special stains for the detection of Zygomycosis. Grocott’s Methanamine Silver (GMS) staining can give false negative results if background staining of reticulum fibers is enhanced. This can occur because of overexposure in silver solution, excessive heat during processing, or use of incorrectly titrated solutions. Three consecutive culture proven cases of cutaneous Zygomycosis infection were evaluated. In each case, organisms were clearly visualized on routine H and E sections while PAS staining was variable. Examples of false negative GMS staining are also shown. Recognition of these staining properties can help dermatopathologists better detect the agents of Zygomycosis.