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In Vivo Gram Staining of Tinea Versicolor

Allyson Spence-Shishido, MD1,2; Christopher Carr, MD1,2; Michael Y. Bonner, BA1,2; Jack L. Arbiser, MD, PhD1,2,3
[+] Author Affiliations
1Department of Dermatology, Emory University School of Medicine, Atlanta, Georgia
2Atlanta Veterans Administration Hospital, Atlanta, Georgia
3Winship Cancer Institute, Atlanta, Georgia
JAMA Dermatol. 2013;149(8):991-992. doi:10.1001/jamadermatol.2013.2699.
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In this report, we demonstrate that tinea versicolor retains topical gentian violet. We did not observe this phenomenon in other hypopigmenting disorders, and thus this observation could be used as a simple bedside test. We call this phenomenon in vivo Gram staining.

Article InformationCorresponding Author: Dr Arbiser, Department of Dermatology, Emory University School of Medicine, WMB 5309, 1639 Pierce Dr, Atlanta, GA 30322 (jarbise@emory.edu).

Published Online: May 15, 2013. doi: 10.1001/jamadermatol.2013.2699

Conflict of Interest Disclosures: None reported.

Funding/Support: Dr Arbiser was supported by Emory Skin Disease Research Core Center grants RO1 AR47901 and P30 AR42687 from the National Institutes of Health, as well as funds from the Rabinowitch-Davis Foundation for Melanoma Research and the Betty Minsk Foundation for Melanoma Research.

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Figure.
Clinical (A and B) and Microscopic (C) Images From the Present Case

A, The patient had a history of tinea versicolor but was uncertain if he had been successfully treated. B, To determine whether he still was colonized with tinea versicolor, topical gentian violet (crystal violet) was applied to his back; note the accentuation of infected patches by gentian violet. C, Confirmation of infection was noted by positive potassium hydroxide preparation, revealing classic “spaghetti and meatball” conformation of fungus (original magnification ×100).

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