Question

What is a potassium hydroxide (koh) test and what specific nursing actions should be taken when obtaining fungal skin specimens?

Answer 1

The potassium hydroxide (KOH) test is a test for fungal infections of the skin. The affected skin is sampled by scraping it off then KOH is added to the glass slide before taking a look at it in the microscope. The KOH dissolves epidermal tissue but does not affect the fungal tissue, leading to direct visualization of the fungal morphology. 

The correct way of collecting a specimen for KOH test is first to collect the specimen using a wooden tongue depressor or the back of the scalpel blade, then placing it inside a plastic container to be sent to pathology laboratory. In cases wherein KOH microscopy is inconclusive, a fungal culture is needed and a punch biopsy of the affected area is warranted. 

Specimens should be labeled by the patient's name, age, specimen, and diagnosis to prevent any mishaps in the laboratory.

Answer 2

When a person’s hair, nails, and skin areas are infected with fungus, such infections are determined by a doctor through the KOH test. While taking a skin sample for the test, the nurse or a doctor must use a scraping tool to remove the infected skin and place it in the KOH solution, which is later examined under the microscope.

Further Explanation:

The KOH or potassium hydroxide test is generally performed to check whether the cause of infection in the skin is a fungus or not. The constituent elements in KOH are potassium (K), hydrogen (H), and oxygen (O), which together produce potassium hydroxide. The products such as soft soaps, fertilizers, and alkaline batteries make use of KOH.

A change on the surface of the skin or skin lesion can be a result of infection through many agents. The KOH test is done when a fungal infection is suspected. The infection through tinea cruris and ringworm are the fungal infections usually determined by the KOH test.

The symptoms of the infection by a fungus include:

• Red, itchy patches on the skin
• When it occurs in the mouth, white patches are seen
• Thickened or deformed nails

The procedure of the test involves the following steps:

• A small area of the skin is scraped through a glass slide or any other instrument.
• The scraped skin is kept in a potassium hydroxide solution.
• The KOH kills the healthy cell while keeping the fungal cells alive.
• A normal KOH test would result in the absence of fungal cells.
• An abnormal test result will have the presence of fungal cells.
• The presence or absence of the fungal infection is determined after examining the solution containing the infected skin area under the microscope.

Therefore, if the KOH solution degrades all the cells, the infection is not done by a fungus. This means that the symptoms might have occurred due to some other infectious agent. In the presence of fungal infection, the doctor might suggest further treatment.

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Answer Details:

Grade: College Biology

Chapter: Fungal Infections

Subject: Biology

Keywords:

KOH test, potassium hydroxide, fungal infection, ringworm, tinea cruris, glass slide, fungal cells.