Subcutaneous mycoses in a tertiary care hospital in India

Abstract

Abstract Background: Subcutaneous mycoses, a disease of the tropics, are usually missed or misdiagnosed in immunocompetent individuals unless sought for. The study was designed to explore the experience of diagnosing subcutaneous mycoses by histopathological examination in our institute and to find out the epidemiology, clinical features, and histopathological findings of cases with subcutaneous mycosis. Methodology: We reviewed the cases reported as subcutaneous mycoses in the department of pathology over 6 years (2017–2022). The slides were stained with Hematoxylin and Eosin, Periodic acid Schiff (PAS), and Gomori’s Methenamine silver (GMS) for identification of the fungi. Clinical details were obtained from the medical records. Results: Twenty-seven cases were retrieved from the archives, reported as subcutaneous mycoses from various sites. They presented with varying symptoms ranging from ulcers, discharging sinuses, nodular swellings, and cystic swelling. Histology from these revealed granulomas with suppuration, necrosis of subcutaneous fat, broad aseptate hyphae with angioinvasion, abscesses, and grains. Conclusion: Mycosis, a disease of the tropics, may manifest in immunocompetent individuals with varied clinical presentations and histology. The intact immune status of the individual results in granuloma formation along with suppuration and giant cells. Diagnosis is usually achieved by a meticulous search for fungus in such lesions. PAS and GMS stains help identify the fungus.