Abstract

Background: Tinea unguium is a common problem seen in clinical practice. Considering the many differential diagnoses of dystrophic nails, it is important to make a definitive diagnosis of dermatophyte infection before the initiation of antifungal therapy. Potassium hydroxide (KOH) preparation and fungal culture, which are commonly used in the diagnosis of these infections, often yield false-negative results. Recent reports have suggested that nail plate biopsy (Bx) using periodic acid-Schiff (PAS) (Bx/PAS) stain may be a very sensitive technique for the diagnosis of tinea unguium.

Objective: The purpose of this study was to evaluate the usefulness of PAS and Grocott's methenamine silver (GMS) staining of nail specimen in the diagnosis of tinea unguium as a standard method.

Methods: We evaluated 75 nail specimens from suspected tinea unguium using KOH preparation, biopsy using periodic acid-Schiff stain, and Grocott's methenamine silver stain.

Results: Of the 75 nails which were negative on potassium hydroxide mounting, 43 and 39 cases were tested positive respectively on periodic acid-Schiff stain and Grocott's methenamine silver stain.

Conclusion: Bx/PAS and Bx/GMS are the sensitive methods for the diagnosis of tinea unguium. They are indicated if clinical suspicion of onychomycosis is high and KOH preparation shows no fungal elements.

Keywords

Rabbits Tinea unguium Periodic acid-Schiff stain Grocott's methenamine silver stain

KJMM 2005 March;10(1):30-34(5). Epub 2016 February 20
Copyright © 2005 by Korean Journal of Medical Mycology

Language

Korean/English

Author

Jiehyun Jeon; Department of Dermatology, College of Medicine, Korea University, Ansan, Korea
Il-Hwan Kim; Department of Dermatology, College of Medicine, Korea University, Ansan, Korea

Corresponding

Il-Hwan Kim, Department of Dermatology, College of Medicine, Korea University, Ansan, Korea. Tel: (031) 412-5986, Fax: (031) 412-5184, e-mail: kumcihk@korea.ac.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.

Jiehyun Jeon

Department of Dermatology, College of Medicine, Korea University, Ansan, Korea

Il-Hwan Kim

Department of Dermatology, College of Medicine, Korea University, Ansan, Korea

Since epub date 2016 February 20