US20030045810A1

US20030045810A1 - Highly sensitive, practical, widely available diagnostic kit for fungal skin infections

Info

Publication number: US20030045810A1
Application number: US10/237,564
Authority: US
Inventors: Piotr Borkowski
Original assignee: Individual
Current assignee: Individual
Priority date: 1999-11-10
Filing date: 2002-09-09
Publication date: 2003-03-06
Also published as: US6447463B1

Abstract

A fungal skin infection diagnostic kit is disclosed with a plurality of components stored within a box. The box can be provided with a colorful, attractive front graphic and may include a photo of a working pathologist, etc. The box can be provided with a hole allowing for easy hanging and display of the product. The kit is used for transferring one or more skin lesions to a remote location, such as a diagnostic lab. The kit can include a plastic diagnostic slide with attached self-adhesive tape, a plastic specimen bag where the slide with attached skin lesion can be placed, medical information and use instructions, and a return envelope. The specimen bag is preferably provided with a zip-type closing mechanism and a bar code with corresponding case number. The return envelope is preferably prepaid. The kit can also include a data form to be filled out by the user for his or her personal information.

Description

BACKGROUND OF THE INVENTION

The present application is a continuation of U.S. patent application Ser. No. 09/708,371, filed Nov. 8, 2000, which claims priority to and the benefit of U.S. Provisional Application No. 60/164,478, filed Nov. 10, 1999.[0001]

FIELD OF INVENTION

The present invention relates to a very sensitive, practical, useful, widely available diagnostic kit for fungal skin infections.

BACKGROUND DESCRIPTION OF ART

Fungal skin infection is a common medical problem worldwide. In the United States, one of every five persons gets a fungal infection at some time. Athlete's foot (tinea pedis) is the most common fungal skin infection. It affects approximately 70 percent of adult population. Many people, especially teenagers and young men will acquire it at least once in a lifetime. Factors predisposing to athlete's foot include heavy sweating, not drying feet after bathing, warm and moist climate, heavy-duty athletic activities and tight shoes and socks, especially made of synthetic materials. Other fungal skin diseases may involve the groin area (jock itch), underarms, legs, face and chest and back (tinea versicolor). Fungal infections of the skin may manifest as skin discoloration (pale, dark, red patches), itching, burning, pain and discomfort. The skin can become brittle and scaling can occur. Occasionally the skin can develop fissures, blisters and ulcers followed by scarring. Infections, if left untreated, may lead to cellulitis, sever pain and discomfort and even to systemic dissemination of the disease. Especially serious problems may be encountered in diabetic and immunocompromised patients. Offensive clinical presentation of the disease can also lead to social stigma with negative effect on self-esteem and social interaction.

A firm, definite diagnosis of fungal skin diseases is crucial before prescribing antifungal agents. All medications carry a potential risk for toxic reactions and drug interactions and many medications are costly. The list of diagnostic tools for fungal skin diseases in a clinical setting includes potassium hydroxide (KOH) preparation, fungal cultures and surgical pathology diagnostic tests. KOH preparation appears to serve as a most commonly utilized diagnostic test followed by cultures. Both KOH and surgical pathology diagnostic tests involve scraping of the superficial layer of skin with scalpel or glass slide edge. This procedure is considered invasive and has to be performed in doctor's office by a trained medical practitioner.

In KOH preparation, the specimen is placed on a microscopic slide, softened by 20% KOH, and heated under a heat source. The specimen is then evaluated microscopically for the presence of fungal elements (yeasts and hyphae). In surgical pathology diagnostic test the skin scrapings are stained with periodic acid-Schiff reaction (PAS) and also examined under microscope. In fungal cultures, the specimen is usually placed on dermatophyte test and Sabouraud dextrose agar media. Cultures are allowed four weeks to grow. At the end of this period, fungal samples are removed from the media, stained with lactophenol blue, and examined microscopically for the identification of specific genus and species. Unfortunately cultures can take as long as a month to grow and approximately 30-40% of cultures may be negative.

Interestingly, in fungal skin infections, the usual location of the causative fungus is in the outermost layer of the skin. This layer is called cornified layer or stratum cornum. This part of the skin is dead and easily detachable. The cell from the cornified layer are constantly slough in a natural process. I made an observation that these cells can even be easily lifted with a self adhesive tape like Scotch tape®. This fact led me to create an idea of highly sensitive, useful, non-invasive, widely available diagnostic kit for fungal skin infections.

SUMMARY OF THE INVENTION

The objectives of the proposed invention are to provide the general public, cosmetologists and health care providers (podiatrists, dermatologists, family practitioners, physical therapists, internists, orthopedists, etc.) with a simple, highly sensitive, useful, practical, non-invasive, safe, informative, widely available, and inexpensive diagnostic kit for fungal skin infection.

The basis of the invention is the usual location of pathogenic fungi within dead, easily detachable outermost layer of the skin. The invention is also based on superior sensitivity and usefulness of histochemical PAS stain in tissue preparations. The Diagnostic Test Kit for fungal skin diseases can include colorful, attractive packaging (FIG. 1). The kit can also include a translucent, plastic diagnostic slide with retractable, self adhesive, centrally translucent tape (FIG. 2). The kit will also contain a plastic, zip-lock type, biohazard specimen bag (FIG. 3) and a return, prepaid envelope (FIG. 4). The kit can include medical information about fungal skin infections and use an instruction booklet. Each kit can have a specific computerized identification number. The user or customer, such as a person with suspicious looking skin changes (e.g. discolored, thickened, fissured, cracked, peeling, itching skin), will preferably be able to purchase the kit in the drug stores, grocery stores, health oriented stores, beauty salons, health salons, doctors offices, etc. The customer can be able to become familiar with medical aspects of fungal skin infections from the medical information booklet. The instructions booklet can specify how to obtain diagnostic sample of cornified layer of the skin using provided plastic slide with attached adhesive tape. (FIG. 2). The suspicious area of the skin can be touched with adhesive part of the tape. The customer can be instructed to reattached the tape to the plastic slide, place the slide in the specimen bag and mail the sample to the skin fungus diagnostic lab using provided prepaid envelope. In the laboratory the slide and the tape can be partially detached and stained with PAS stain. A pathologist can read the slide and make the diagnosis for presence or absence of fungal skin infection. A written result report can be faxed/mailed to the clinician in charge of the patient/customer or send to the computerized, telephone or Internet report system. The customer can then have the opportunity to obtain the diagnosis and medical recommendation message over the phone (or internet) using his identification number. The specimen processing system offers opportunity for potential automatization. Trained technicians could also prescreen the slides.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 is a front perspective view of the Fungal Skin Infections Diagnostic Kit box; [0009]
FIG. 2 illustrates plastic diagnostic slide with attached self-adhesive tape; [0010]
FIG. 3 is a front perspective view of a plastic specimen bag; [0011]
FIG. 4 is a front perspective view of a prepaid return envelope; [0012]
FIG. 5 is a front perspective view of the plastic diagnostic slide with attached self-adhesive tape and a view of a fungal skin lesion; [0013]
FIG. 6 is a front perspective view of a plastic diagnostic slide with an opened self-adhesive tape and a view of the fungal skin lesion located behind the tape central translucent window; [0014]
FIG. 7 illustrates clinician's (or customer's) hands holding the diagnostic slide and gently pressing the adhesive tape against easily visible skin lesion; [0015]
FIG. 8 is a front perspective view of the plastic diagnostic slide with reattached adhesive tape; [0016]
FIG. 9 is a front perspective view of the plastic diagnostic slide with attached self-adhesive tape received in the lab; [0017]
FIG. 10 is a front perspective view of the plastic diagnostic slide with partially detached self-adhesive tape receive in the lab; [0018]
FIG. 11 is a front ([0019] 3 a) and side (3 b) perspective view of a plastic diagnostic slide with a slightly detached self-adhesive tape for staining with PAS; and
FIG. 12 is a front perspective view of a stained plastic diagnostic slide with reattached adhesive tape ready for microscopic examination.[0020]

DETAILED DESCRIPTION OF THE INVENTION

Referring to FIG. 1, Fungal Skin Infections [0021] Diagnostic Kit box 1 has a colorful, attractive front graphic 2 that may include a photo of working pathologist etc. The box can be provided with a hole 3 allowing easy hanging and display of the product. As illustrated in FIG. 2 the kit can include a plastic diagnostic slide 1 with attached self-adhesive tape 2. The adhesive tape preferably has a translucent window 3, bar code 4, corresponding to bar code number 5 and rectangular piece of glossy paper 6 attached to the back of a free end of adhesive tape. Alternatively or additionally, the bar code and/or bar code number can also be provided on the specimen bag. The other end of the tape is preferably attached permanently to the edge 7 of plastic slide.
In lieu of the self adhesive tape, other non-intrusive, non-traumatic removal means can be used and all are considered within the scope of the invention. One alternative can be a sponge or sponge-like member. Other devices which allow for easy access to and removal of the outermost layer of the individuals skin are also within the scope of the invention. [0022]
FIG. 3 shows a [0023] plastic specimen bag 1 where the plastic diagnostic slide will be placed. The bag has a zip-type closing mechanism 2. In FIG. 4 prepaid return envelope 1 shows typical U.S. postal service specification elements. The type of used envelopes should be of good quality, plastic lined, tight and easily self sealed for added safety and security.
FIG. 5 shows a plastic [0024] diagnostic slide 1 described above. It also shows a simplified drawing of a fungal skin lesion 2. FIG. 6 shows a plastic diagnostic slide 1 with an opened self adhesive tape 2 and a view of the fungal skin lesion 3 located behind the tape central translucent window 4. FIG. 7 illustrates clinician's (or customer's) hands 1 holding the diagnostic slide 2 and gently pressing the adhesive tape 3 against easily visible skin lesion 4. FIG. 8 shows plastic diagnostic slide with reattached adhesive tape.
FIG. 9 shows a plastic diagnostic slide as received in a Skin Fungus Diagnostic Lab. FIG. 10 illustrates plastic [0025] diagnostic slide 1 with an opened self-adhesive tape 2 and removed rectangular piece of glossy paper 3. FIG. 11 shows a front (3 a) and side (3 b) perspective view of a plastic diagnostic slide with a slightly detached self-adhesive tape for staining with PAS. This detachment allows chemicals to react with fungal elements attached together with dead squamous cells of the skin to the adhesive tape. FIG. 12 shows a plastic diagnostic slide with reattached adhesive tape for microscopic examination.
The kit can also include a data form to be filled out by the user. The form can request information concerning how long the skin has been infected, personal data on the customer, color of skin, other description of the skin (i.e. flaky, friable, etc.), any previous conditions, age, sex, insurance information, whether skin lesion is causing pain, whether skin is infected, etc. Other information is also within the scope of the invention. [0026]

Preliminary Experiment

Preliminary experiment involved a single patient with multiple fungal skin infection lesions located on his chest and back (tinea versicolor). The skin lesions presented as multiple, pale patches ranging in size from 3 cm to 0.3 cm in greatest dimension. The lesions were not painful, however cosmetically unpleasant. Ten (10) lesions were selected randomly. Each lesion was touched with a piece of a Scotch tape®. The tape fragments were than attached to glass slides and stained with PAS. All slides were positive for fungal hyphae, a diagnostic finding of fungal skin infection. Identical experiment was repeated with a healthy person as a control. All ten (10) control slides were negative. Although broad studies will be necessary for statistically significant conclusions, the above experiment is strongly supportive of the idea of a highly sensitive, practical, widely available diagnostic kit for fungal skin infections. [0027]
The instant invention has been shown and described herein in what is considered to be the most practical and preferred embodiment. It is recognized, however, that departures may be made therefrom within the scope of the invention and that obvious modifications will occur to a person skilled in the art. [0028]

Claims

What is claimed is:

1. A kit for transferring superficial skin lesions to a remote location for diagnostic testing for fungal skin infections, said kit comprising:

a specimen bag defining a receiving area for storage of the skin lesion to be analyzed; and

an envelope containing the address of the remote location, said specimen bag having said skin lesion stored within said receiving area disposed within said envelope when mailing said envelope to the remote location.

2. The kit of claim 1 wherein said envelope is a return, prepaid envelope.

3. The kit of claim 1 further including medical information regarding fungal skin infections and use instructions.

4. The kit of claim 1 further including means for storing said envelope and said specimen bag prior to use.

5. The kit of claim 4 wherein said means for storing is a box-like member; wherein said envelope and said specimen bag contained within said box-like member prior to use.

6. The kit of claim 4 further including means for non-intrusive removal of a superficial skin lesion from an individual's body.

7. The kit of claim 6 wherein said means for non-intrusive removal is a slide with attached self-adhesive tape.

8. The kit of claim 1 wherein said specimen bag is a biohazard bag having a zip-lock type closure mechanism.

9. The kit of claim 6, said means for non-intrusive removal having a specific identification number.

10. The kit of claim 9 wherein said specific identification number is a bar code and corresponding case number.

12. The kit of claim 1 further including a data form for filling out by a user.

13. A kit for transferring superficial skin lesions to a remote location for diagnostic testing for fungal skin infections, said kit comprising:

means for non-intrusive removal of a superficial skin lesion from an individual's body; and

an envelope containing the address of the remote location, said skin lesion stored within said envelope when mailing said envelope to the remote location.

14. The kit of claim 13 wherein said envelope is a return, prepaid envelope.

15. The kit of claim 13 further including medical information regarding fungal skin infections and use instructions.

16. The kit of claim 13 further including means for storing said envelope and said means for non-intrusive removal prior to use.

17. The kit of claim 16 wherein said means for storing is a box-like member; wherein said envelope and said means for non-intrusive removal contained within said box-like member prior to use.

18. The kit of claim 13 wherein said means for non-intrusive removal is a slide with attached self-adhesive tape.

19. The kit of claim 13, said means for non-intrusive removal having a specific identification number.

20. The kit of claim 19 wherein said specific identification number is a bar code and corresponding case number.

21. The kit of claim 13 further including a data form for filling out by a user.

22. A method for transferring a skin lesion to a remote location for diagnostic testing for fungal skin infections, said method comprising the steps of:

(a) removing a skin lesion from its attachment to an individual;

(b) placing said skin lesion in an envelope; and

(c) mailing the envelope to a remote location.

23. The method for transferring a skin lesion of claim 22 further including the step of filling out a data form about the individual and inserting the data form within the envelope prior to mailing the envelope to the remote location.

24. The method for transferring a skin lesion of claim 22 wherein step (a) comprises contacting an outermost skin layer of the individual associated with the skin lesion with a self-adhesive tape and attaching said tape with skin lesion to a slide.

25. The method for transferring a skin lesion of claim 22 wherein step (b) comprises inserting the slide with attached skin lesion within the envelope.

26. The method for transferring a skin lesion of claim 22 wherein step (b) comprises providing a specimen bag and inserting the slide with attached skin lesion within the specimen bag.