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Novel B-DNA Dermatophyte Assay for Demonstration of Canonical DNA in Dermatophytes: Histopathologic Characterization by Artificial Intelligence.

Clinics in Dermatology 2024 January 6
We describe a novel assay and artificial intelligence (AI) driven histopathologic approach identifying dermatophytes in human skin tissue sections (i.e., B-DNA dermatophyte assay) and demonstrate, for the first time, the presence of dermatophytes in tissue using immunohistochemistry (IHC) to detect canonical right-handed double-stranded (ds-) B-DNA. IHC was performed using anti-ds-B-DNA monoclonal antibodies with formalin-fixed paraffin-embedded tissues to determine the presence of dermatophytes. The B-DNA assay resulted in a more accurate identification of dermatophytes, nuclear morphology, dimensions, and gene expression of dermatophytes (i.e., optical density values) than Periodic acid-Schiff (PAS), Grocott methenamine silver (GMS), or hematoxylin-eosin (H&E) stains. The novel assay guided by AI, allowed for efficient identification of different types of dermatophytes, e.g., hyphae, microconidia, macroconidia, and arthroconidia. Using the B-DNA dermatophyte assay as a clinical tool for diagnosing dermatophytes is an alternative to PAS, GMS, and H&E, as a fast and inexpensive way to accurately detect dermatophytosis and reduce the number of false-negatives. Our assay resulted in superior identification, sensitivity, life cycle stages and morphology compared to H&E, PAS, and GMS stains. This method detects a specific structural marker, i.e., ds-B-DNA, which can assist with diagnosis of dermatophytes. It represents a significant advantage over methods currently in use.

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