Differentiating superficial fungal infection from eczema using a heated dynamic-headspace skin VOC sampler: a hypothesis

Superficial fungal infections and eczematous dermatitis often present with similar clinical features including erythema, scale, and itching, leading to empiric treatment and delayed diagnosis. Existing confirmatory tests such as potassium hydroxide microscopy, fungal culture, and polymerase chain reaction have limitations related to operator dependence, turnaround time, availability, and cost. Researchers hypothesize that these conditions produce distinct volatile organic compound signatures in the skin, as fungal lesions reflect organism-specific metabolic pathways while eczematous lesions are primarily shaped by barrier dysfunction, oxidative stress, and altered microbial communities. Dermatophytes, Candida species, and Malassezia species are expected to contribute characteristic alcohols, esters, and ketones, while eczema is expected to be enriched in lipid peroxidation products. Heated dynamic headspace sampling offers a practical strategy to capture these compounds under controlled conditions. If validated, skin volatile profiling could serve as a rapid adjunctive diagnostic tool to support confirmatory testing and guide treatment management.