Diagnosis
Diagnosis is by biopsy, visualising the fungi under the microscope and culture, which show characteristic fungal filaments and vesicles characteristic of the fungi. Other tests include ELISA, immunodiffusion, and PCR with DNA sequencing (so-called DNA barcoding).X rays and ultrasonography may be carried out to assess the extent of the disease. X rays findings are extremely variable. The disease is most often observed at an advanced stage that exhibits extensive destruction of all bones of the foot. Rarely, a single lesion may be seen in the tibia where the picture is identical with chronic osteomyelitis. Cytology of fine needle aspirate or pus from the lesion, and tissue biopsy may be undertaken sometimes. Some publications have claimed a "dot in a circle sign" as a characteristic MRI feature for this condition (this feature has also been described on ultrasound). Differential diagnosis
The following clinical conditions may be considered before diagnosing a patient with mycetoma:

Tuberculous ulcer
Kaposis sarcoma, a vascular tumour of skin usually seen in AIDS. Leprosy
Syphilis
Malignant neoplasm
Tropical ulcer
Botryomycosis, a skin infection usually caused by the bacteria Staphylococcus aureus. Prevention
No vaccine is available. Simple hygienic precautions like wearing shoes or sandals while working in fields, and washing hands and feet at regular intervals may help prevent the disease. Treatment
Surgery combined with itraconazole may be given for up to year when the grains are black. Posaconazole is another option. Voriconazole can be used for infections caused by Fusarium species.Ketoconazole has been used to treat eumycetoma but has many side effects.
Irritant contact dermatitis is a form of contact dermatitis that can be divided into forms caused by chemical irritants and those caused by physical irritants. Chemical
Chemical irritant contact dermatitis is either acute or chronic, which is usually associated with strong and weak irritants respectively. The following definition is provided by Mathias and Maibach (1978): The mechanism of action varies. Detergents, surfactants, extremes of pH, and organic solvents all directly affecting the barrier properties of the epidermis. These effects include removing fat emulsion, defatting of dermal lipids, inflicting cellular damage on the epithelium, and increasing the transepidermal water loss by damaging the horny layer water-binding mechanisms and damaging the DNA, which causes the layer to thin. Concentrated irritants have an acute effect, but this is not as common as the accumulative, chronic effect of irritants whose deleterious effects build up with subsequent doses (ESCD 2006). Chemical irritants are often strong alkalis as found in drain cleaners and soap with lye residues. Many other chemical compounds can also cause contact dermatitis. Physical
Physical irritant contact dermatitis is a less-researched form of irritant contact dermatitis due to its various mechanisms of action and a lack of a test for its diagnosis. A complete patient history combined with negative allergic patch testing is usually necessary to reach a correct diagnosis. The simplest form of physical irritant contact dermatitis results from prolonged rubbing, although the diversity of implicated irritants is far wider. Examples include paper friction, fiberglass, and scratchy clothing.