Abstract

For the sake of simplicity, it is as well to divide nail pathogens into dermatophytes (moulds) and yeasts. Most dermatophyte infections of nails, some over 80% are caused by Trichophyton rubrum (T. rubrum), with Trichophyton mentagrophytes (T. mentagrophytes) found in around 10% of cases. Occasionally there are mixed or pure infections with yeast mostly Candida albicans. Rarely nondermatophytic fungi such as Scopolariopsis, Aspergillus, Scytalidium and Fusarium species are found to be causative agents in onychomycosis. Importance of accurate diagnosis of onychomycosis has been increasing because more than half of the patients with nail disorders are non-onychomycotic. Direct smear with KOH is the most simple and valuable laboratory test which will takes about 20 to 30 minutes. the positive rate of direct smear is relatively high (40~60%), but permanent keeping of the positive microscopic findings is not possible. Fungus culture is the most essential laboratory test for identifying the species of the causative fungi even though the positive rate is low (20~50%) and takes 3 to 4 week to have the result. Histopathologic test is a non-invasive diagnostic method with high positive rate (70~90%). The test is very helpful for confirming the mixed infection of the onychomycosis. KONCPA test abbreviated by "melting with KOH of the nail clippings and PAS staining" is a new

diagnostic method. Though the test requires some skill and equipments, the positive rate is high (70~90%) and permanent keeping of the positive findings is possible.

Keywords

Onychomycosis Causative agents Diagnosis

KJMM 2005 June;10(2):41-45(5). Epub 2016 February 20
Copyright © 2005 by Korean Journal of Medical Mycology

Language

Korean/English

Author

Kee Chan Moon; Department of Dermatology, College of Medicine, University of Ulsan, Seoul, Korea
Baik Kee Cho; Department of Dermatology, College of Medicine, The Catholic University of Korea, Seoul, Korea

Corresponding

Kee Chan Moon, Department of Dermatology, College of Medicine, University of Ulsan, Seoul, Korea. Tel: (02) 3010-3460, Fax: (02) 486-7831, e-mail: kcmoons@amc.seoul.kr

Publication history

Acknowledgements

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Kee Chan Moon

Department of Dermatology, College of Medicine, University of Ulsan, Seoul, Korea

Baik Kee Cho

Department of Dermatology, College of Medicine, The Catholic University of Korea, Seoul, Korea

Since epub date 2016 February 20