A Preliminary Study to Determine the Diagnostic Capability of a Wood’s Lamp for Cutaneous Fungal Infections in Underserved Areas of the Dominican Republic

Skin infections caused by bacteria, fungi, and viruses are frequently encountered by physicians and healthcare providers worldwide. Fungal infections, particularly of the skin, are a chronic issue in areas with a tropical, humid climate. A common group of cutaneous fungal infections are the dermatophytes (Tinea). These infections are from molds including Trichophyton, Microsporum and Epidermophyton. Wood's lamp examination, which utilizes ultraviolet light, is another method to screen for fungal skin infections. Several fungal species (i.e. Microsporum, Malassezia) characteristically fluoresce bright green or gold under UV light and can provide a clue as to whether fungi are present. A Wood's Lamp was positioned next to the suspected lesion to determine if the lesion fluoresced. The scraping was then obtained through the use of a scalpel using gentle pressure to prevent any pain or discomfort. Immersion oil was placed on the scraping on a microscope slide. The scrapings were then stained with iodine and observed under a microscope to look for the presence of hyphae, which would indicate a positive fungal infection. The preliminary study consisted of 23 patients with suspected asymptomatic dermatological fungal infections. Of the 23 lesions, 11 fluoresced with UV light, but of those 11, only 8 showed hyphae and 2 showed yeast. Upon reviewing our results, it appears that a Wood's lamp exam is not an efficient diagnostic indicator for cutaneous fungal infections. The Wood's lamp has a fairly high specificity for fungal infections, but the sensitivity was lacking due to a number of the cutaneous fungi not fluorescing when exposed to UV light. Despite the lack of significant data, we believe that the Wood's lamp would be a beneficial tool to have in poorer rural clinics in the developing world. We also believe that it would be a significant help for medical students in making a more confident diagnosis of cutaneous fungal infections, and therefore providing better patient diagnosis and treatment while on medical volunteer mission trips.