Abstract Background: Subcutaneous swellings encompass a broad spectrum of conditions, ranging from epidermoid cysts to neoplastic lesions. Among these, subcutaneous mycoses involving the dermis and subcutaneous tissue are a frequent cause, particularly in individuals from rural areas engaged in outdoor occupations. These infections may initially produce minimal tissue reaction or mild spongiosis, which can progress to psoriasiform spongiosis accompanied by a mixed inflammatory infiltrate in the dermis. Early detection through fine-needle aspiration cytology (FNAC) facilitates timely treatment initiation while awaiting histopathological confirmation. Materials and Methods: This prospective cross-sectional study was conducted over 3 years (January 2022 to December 2025) in the Departments of Cytopathology, Histopathology, and Microbiology at SCB Medical College and Hospital, Cuttack, Odisha, India. All FNAC cases suggestive of fungal infection, as well as histopathologically confirmed cases, were included in the analysis. Clinical details, including age, gender, occupation, presenting complaints, duration of symptoms, anatomical site, and aggravating or relieving factors, were documented. Radiological investigations were performed whenever required to support the final diagnosis. Results: A total of 36 cases were evaluated, with a male predominance (58.3%), and the highest incidence was observed in the 31- to 40-year age group. The lower extremities were most commonly involved (75%), particularly the foot. A history of preceding trauma was reported in 27 cases. Conclusion: Although tissue culture remains the gold standard for diagnosing cutaneous and subcutaneous mycoses, cytomorphological assessment and histopathological examination serve as important complementary diagnostic modalities. A definitive diagnosis can be reliably established using special histochemical stains such as periodic acid–Schiff, which is rapid and straightforward, and Grocott’s methenamine silver (GMS), which allows accurate morphological identification of fungal elements.
Mohapatro et al. (Thu,) studied this question.