International journal of dermatology

A comparison of the contrast stains, Chicago blue, chlorazole black, and Parker ink, for the rapid diagnosis of skin and nail infections.

PMID 22788809


The cheapest, most rapid method for the diagnosis of mycotic skin and nail infections is direct examination of samples using a KOH preparation. The standard KOH wet mount lacks a color contrast. Various contrast dyes are available. Parker ink is one which has been extensively used, however in recent times the stain no longer provides a suitable color contrast. Two other dyes that are available are Chicago blue and chlorazole black. 100 samples of skin or nails were prospectively examined using Chicago blue, chlorazole black, and Parker ink-KOH stains. The samples were also cultured, with culture being the diagnostic gold standard. The sensitivities and specificities of the Chicago blue, chlorazole black and Parker ink stains were 78% & 96%; 63% & 97%; and 48% and 96%, respectively. The Chicago blue-KOH stain provides a good color contrast and is a suitable replacement for the Parker ink-KOH stain. It is suitable for use in the dermatologist's office or in the laboratory.