Athlete's Foot - Diagnosis

Diagnosis

Athlete's foot can usually be diagnosed by visual inspection of the skin, but where the diagnosis is in doubt direct microscopy of a potassium hydroxide preparation (known as a KOH test) may help rule out other possible causes, such as eczema or psoriasis. A KOH preparation is performed by taking skin scrapings which are covered with 10% to 20% potassium hydroxide applied to the microscope slide; after a few minutes the skin cells are degraded by the KOH and the characteristic fungal hyphae can then be seen microscopically, either with or without the assistance of a stain. The KOH preparation has an excellent positive predictive value, but occasionally false negative results may be obtained, especially if treatment with an antifungal medication has already begun.

If the above diagnoses are inconclusive or if a treatment regimen has already been started, a biopsy of the affected skin (i.e. a sample of the living skin tissue) can be taken for histological examination.

A Wood's lamp, although useful in diagnosing fungal infections of the scalp (tinea capitis), is not usually helpful in diagnosing tinea pedis, since the common dermatophytes that cause this disease do not fluoresce under ultraviolet light. However, it can be useful for determining if the disease is due to a nonfungal afflictor.