Antifungal susceptibility testing for dermatophytes isolated from clinical samples by broth dilution method in a tertiary care hospital

Purpose: To characterize antifungal susceptibility pattern of different species of dermatophytes isolated from clinical patients in a multispeciality hospital. Method: Micro broth dilution method was used to determine Minimum inhibitory concentration (MIC) for 129 positive samples with reference to CLSI document M38-A2. MIC was done against amphotericin B, fluconazole, ketoconazole, terbinafine, ciclopirox and griseofulvin. Results: The range of MIC was within the normal susceptibility range of the standard strain (Trichophyton mentagrophytes ATCC MYA – 4439) mentioned in CLSI document M-38 A2. Conclusion: No resistant strains were isolated in our study with reference to the standard testing method. None of the isolates have showed abnormal MIC range when compared to MIC of standard strain reported in literature. Hence, the isolates in our study are found to be susceptible to the antifungals used. However, future studies are required to evaluate the effect of drugs upon clinical response.

Granular cell tumor in inguinal region: A case of mistaken identity on cytology

A 63-year-old male presented with sudden increase in size of a right inguinal swelling which was present for the past 10 years. Clinical diagnosis of inguinal soft tissue mass/lymph node enlargement was made and patient was investigated further for a conclusive diagnosis. Ultrasound examination suggested it to be a lymph node and guided fine needle aspiration cytology was performed. Cytology was suggestive of a reactive lymph node. Subsequently, an excision biopsy was performed that revealed a granular cell tumor with many lymphoid aggregates. On reviewing the cytosmears, we realised that the granular neoplastic cells were mistaken for histiocytes; and the lymphoid background and bare nuclei mislead us to consider it a reactive lymph node. Since granular cell tumor can occur almost anywhere, a careful examination of cytosmears and knowledge of its distinctive cyto-morphological features would be helpful in providing an accurate diagnosis on cytology.

Installation of solarium--2000 for phototherapy

Sunlight is the cheapest and most easily available source of ultraviolet light for phototherapy. The disadvantage of using sunlight as the source of ultraviolet light includes its variation with time , place and season, lack of privacy, and atmospheric conditions. To ensure correct dose of UV light in spite of variation in irradiation from the sunlight,we used a PMA2100 meter [Figure:2] and 2110 UVA detector ( Solar light Co, Philadelphia). Privacy for the patients was achieved by erecting a solarium and incidental UVB radiation was cut off by using window glass as the roof of the solarium. We recommend the solarium as a less expensive alternative to artificial phototherapy units, especially in places where there is plenty of sunlight.