Journal of cutaneous pathology · 2025
The Diagnostic Value of Autofluorescence in Hematoxylin-Eosin-Stained Sections for Cutaneous Sporotrichosis.
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Wang Xiaopo, Huang Yuying
Аннотация
BACKGROUND: Previous studies suggest that autofluorescence of pathogenic fungi in hematoxylin-eosin (HE) stained sections under ultraviolet (UV) light may offer rapid screening for fungal infections.
AIMS: To evaluate the diagnostic utility of autofluorescence in HE-stained sections for cutaneous sporotrichosis and compare it with Periodic acid-Schiff (PAS) and Gomori's methenamine silver (GMS) staining.
METHODS: A retrospective analysis included 49 fungal culture-confirmed sporotrichosis cases and eight chromoblastomycosis controls from 2022 to 2024. HE-, PAS-, and GMS-stained sections were examined. Autofluorescence in HE-stained sections was assessed using fluorescent microscopy at UV light mode (340-380 nm).
RESULTS: Most patients presented with fixed cutaneous lesions (65.31%, n = 32), predominantly on the upper extremities (73.47%, n = 36). Histologically, suppurative granuloma (55.10%, n = 27) was the most common pattern. Autofluorescence revealed Sporothrix spores with peripheral green-yellow fluorescence against an olive-yellow background, though erythrocyte interference limited detection in hemorrhagic areas. Only 12/49 cases (24.5%) were autofluorescence-positive, all of which were also PAS- or GMS-positive. Sensitivity was significantly lower than PAS (34.7%, p* = 0.063) and GMS (38.8%, p* = 0.021). No false positive occurred in chromoblastomycosis controls. Interobserver agreement was near-perfect (κ = 0.91).
CONCLUSION: Autofluorescence enables rapid Sporothrix detection with perfect specificity and excellent interobserver agreement, but its low sensitivity limits standalone use. PAS and GMS remain superior for definitive diagnosis. While its reagent-free, cost-effective nature supports adjunct screening where special stains are unavailable, erythrocyte interference and technical variability require protocol optimization.
AIMS: To evaluate the diagnostic utility of autofluorescence in HE-stained sections for cutaneous sporotrichosis and compare it with Periodic acid-Schiff (PAS) and Gomori's methenamine silver (GMS) staining.
METHODS: A retrospective analysis included 49 fungal culture-confirmed sporotrichosis cases and eight chromoblastomycosis controls from 2022 to 2024. HE-, PAS-, and GMS-stained sections were examined. Autofluorescence in HE-stained sections was assessed using fluorescent microscopy at UV light mode (340-380 nm).
RESULTS: Most patients presented with fixed cutaneous lesions (65.31%, n = 32), predominantly on the upper extremities (73.47%, n = 36). Histologically, suppurative granuloma (55.10%, n = 27) was the most common pattern. Autofluorescence revealed Sporothrix spores with peripheral green-yellow fluorescence against an olive-yellow background, though erythrocyte interference limited detection in hemorrhagic areas. Only 12/49 cases (24.5%) were autofluorescence-positive, all of which were also PAS- or GMS-positive. Sensitivity was significantly lower than PAS (34.7%, p* = 0.063) and GMS (38.8%, p* = 0.021). No false positive occurred in chromoblastomycosis controls. Interobserver agreement was near-perfect (κ = 0.91).
CONCLUSION: Autofluorescence enables rapid Sporothrix detection with perfect specificity and excellent interobserver agreement, but its low sensitivity limits standalone use. PAS and GMS remain superior for definitive diagnosis. While its reagent-free, cost-effective nature supports adjunct screening where special stains are unavailable, erythrocyte interference and technical variability require protocol optimization.