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I would like to show you the skin stretch test that helps in the diagnosis of fungal infections like Tinea Versicolor (Pityriasis vers). This test is found negative in other skin lesions. For example: Pityriasis alba, leucoderma, birth marks, scars, etc.
Procedure: keep two fingers one either sides of the skin patch and repeatedly stretch the skin for a few seconds (as given in the second image). Repeat the same by keeping the fingers right angle to the previous direction, so that the circular lesion is stretched from all four directions. When we do this, the scales present in Tinea get separated from the skin; hence the lesion becomes more prominent and clearly visible (compare the visibility of the circular lesion in both images).
· Ask the patient not to use ointments or oils on the skin before doing this test, because only dry skin shows this test.
· The test is difficult to elicit when the skin in wet due to sweating and after a shower.
· Do not do this in psoriasis and skin lesions with cracks, because it may hurt the patient.
I am doing this test since several years, which I learned from my experience when I noticed the lesions become more prominent while examining the patches. I have never read this in books, not even heard. So, I named this test as Rafeeque’s Skin Stretch Test (Due to a wrong impression that I am the first person to do this). But, dear friends, google search really disappointed me! This test is already there in dermatology. The existence of more intelligent people in the past and present era is not my mistake :) . so, I deserve a little credit for this! Right?
Copyright: Dr Muhammed Rafeeque