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Nail Specimens
- Clean affected toenails and fingernails with a pre-moistened alcohol
prep. If the nail is heavily soiled, wash with soap and water first.
- Clip the nail as far back as possible without excessive patient
discomfort.
- Position the Dermapak collection envelope under the nail.
- Obtain the crumbling subungual debris from under the trimmed edge of
the nail by scraping with a 1 mm or 2 mm serrated curette, a 2 mm dental
spatula, or a 15 blade scalpel.
- Fold the Dermapak according to label directions - do not tape or
staple - and record patient name, physician name, and date of collection
on the reverse. Place the Dermapak in the plastic bag provided and mail
in the return envelope.
Hair Specimens
- Trim hairs close to the root or pluck broken hairs with tweezers.
Hairs that fluoresce under a Wood’s light ( those infected by certain
Microsporum spp.) should be selected.
- Scalp specimens may be collected by scraping with a scalpel, or less
traumatically by rubbing a toothbrush or moistened gauze pad over the
affected area.
- Loose hairs may be submitted in a Dermapak - please clearly mark the
Dermapak as containing hair specimen. Alternatively, the hairs and scale
may be plated directly onto appropriate agar plates (potato dextrose and
Mycosel agar).
- If kerion is present, aspirate any fluid and place into a sterile
red top vacutainer tube. Pustules may be swabbed with a cotton-tipped
applicator and sent dry to the laboratory. If using a Culturette, do not
crush the ampule at the base of the container - the cotton tip should
remain dry.
- Label all Dermapaks, plates, or culturettes with patient name,
physician name, and date of collection.
Skin Specimens
- Clean affected areas gently with soap and water or an alcohol prep
to reduce bacterial contamination. Allow the area to dry thoroughly.
- With a #15 blade or edge of a glass microscope slide, gently collect
10-15 pieces of scale from the raised edges of the lesions directly onto
the Dermapak.
- If blisters are present, the roof of the blister can be collected
and sent in the Dermapak.
- Skin biopsy specimens should be placed in a sterile red top
vacutainer tube with or without a small amount of sterile distilled
water.
- Seal and label the Dermapak with patient name, physician name, and
date.
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Proper Collection of a Toenail Specimen
1. Clean nail with alcohol pad.
2. Clip
toenail as far back as is comfortable for the patient.
3. Use a 1 mm curette to collect
subungual debris.
4. Example of a good specimen to be sent to CMM. |
Submission of Specimens to the Mycology Reference Laboratory
- Place Dermapaks in return envelope with complete, signed
requisition and patient insurance information.
- Place agar plates in a box with sufficient packing, along with the
requisition and insurance information.
- Ensure the purity of the culture before mailing. Label the plate
with patient name, physician name, and date of collection.
- Include a complete, signed requisition and patient insurance
information. If the culture is for antifungal susceptibility testing,
please indicate the identification of the organism as well as the
drugs requested.
- Mail specimens via the U.S. postal service or an express courier
following their established guidelines.
DIRECTIONS FOR DERMAPAK USE
- Holding Dermapak with adhesive strip at the top, crease along the
bottom fold line (flap A).
- Place specimen onto central blue portion of Dermapak.
- Fold in the small side flaps (flaps B and C).
- Fold up flap A.
- Remove the adhesive strip and fold down top flap (flap D), sealing
the Dermapak.
- Fill out the information requested on the reverse side.
- Do not tape or staple the Dermapak closed.
- Place the Dermapak into the plastic bag and seal.
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CAUTION: STATIC ELECTRICITY CAUSES
SUBUNGUAL DEBRIS, HAIR SAMPLES, AND/OR SKIN SCRAPINGS TO ADHERE TO
PLASTIC. PLEASE DO NOT PLACE THE SPECIMEN DIRECTLY INTO
THE PLASTIC BAG !
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