Skip to main content
Erschienen in: Current Fungal Infection Reports 3/2017

08.07.2017 | Fungal Infections of Skin and Subcutaneous Tissue (A Bonifaz, Section Editor)

Onychomycosis Laboratory Diagnosis: Review

verfasst von: Jose Manuel Rios-Yuil

Erschienen in: Current Fungal Infection Reports | Ausgabe 3/2017

Einloggen, um Zugang zu erhalten

Abstract

Purpose of Review

Onychomycosis is a growing global health problem. Proper diagnosis is important in order to avoid the risks of unnecessary treatments. This review summarizes the laboratory techniques currently available for the diagnosis of onychomycosis with the advantages and disadvantages of each test.

Recent Findings

Research is underway to prove the clinical utility of other diagnostic techniques such as PAS-stained nail biopsies and molecular tests as viable alternatives for the diagnosis of onychomycosis with promissory results.

Summary

Dermoscopy can be helpful to differentiate onychomycosis from traumatic onycholysis or true melanonychia; however, a definitive diagnosis requires the demonstration of the presence of the fungi. The combination of direct microscopy using potassium hydroxide and fungal culture is the gold standard for the diagnosis of onychomycosis; however, other alternatives, such as calcofluor white under fluorescence, PAS-stained nail biopsies, and molecular techniques have proven to be excellent methods with their advantages and limitations.
Literatur
1.
Zurück zum Zitat Asz-Sigall D, Tosti A, Arenas R. Tinea Uunguium: Ddiagnosis and Ttreatment in Ppractice. Mycopathologia. 2017;182:95–100.CrossRefPubMed Asz-Sigall D, Tosti A, Arenas R. Tinea Uunguium: Ddiagnosis and Ttreatment in Ppractice. Mycopathologia. 2017;182:95–100.CrossRefPubMed
2.
Zurück zum Zitat • Bonifaz A, Rios-Yuil JM, Arenas R, Araiza J, Fernández R, Mercadillo-Pérez P, et al. Comparison of direct microscopy, culture and calcofluor white for the diagnosis of onychomycosis. Rev. Iberoam Micol. 2013;30:109–11. Study highlighting the usefulness of CW CrossRefPubMed • Bonifaz A, Rios-Yuil JM, Arenas R, Araiza J, Fernández R, Mercadillo-Pérez P, et al. Comparison of direct microscopy, culture and calcofluor white for the diagnosis of onychomycosis. Rev. Iberoam Micol. 2013;30:109–11. Study highlighting the usefulness of CW CrossRefPubMed
3.
Zurück zum Zitat • Rios-Yuil JM, Bonifaz A, Arenas R, Araiza J, Fernández R, Mercadillo-Pérez P, et al. Mycological studies of nail samples obtained by curettage vs. vertical perforation of the nail plate. J Eur Acad Dermatol Venereol. 2013;27:1189–90. Study comparing nail sampling techniques CrossRefPubMed • Rios-Yuil JM, Bonifaz A, Arenas R, Araiza J, Fernández R, Mercadillo-Pérez P, et al. Mycological studies of nail samples obtained by curettage vs. vertical perforation of the nail plate. J Eur Acad Dermatol Venereol. 2013;27:1189–90. Study comparing nail sampling techniques CrossRefPubMed
4.
Zurück zum Zitat Kaur R, Kashyap B, Bhalla P. Onychomycosis – Eepidemiology, Ddiagnosis and Mmanagement. Indian J Med Microbiol. 2008;26:108–16.CrossRefPubMed Kaur R, Kashyap B, Bhalla P. Onychomycosis – Eepidemiology, Ddiagnosis and Mmanagement. Indian J Med Microbiol. 2008;26:108–16.CrossRefPubMed
5.
Zurück zum Zitat •• Velasquez-Agudelo V, Cardona-Arias JA. Meta-analysis of the utility of culture, biopsy, and direct KOH examination for the diagnosis of onychomycosis. BMC Infect Dis. 2017;17:166. Meta-analysis showing PAS-staining is a very good alternative for the diagnosis of onychomycosis CrossRefPubMedPubMedCentral •• Velasquez-Agudelo V, Cardona-Arias JA. Meta-analysis of the utility of culture, biopsy, and direct KOH examination for the diagnosis of onychomycosis. BMC Infect Dis. 2017;17:166. Meta-analysis showing PAS-staining is a very good alternative for the diagnosis of onychomycosis CrossRefPubMedPubMedCentral
6.
Zurück zum Zitat • Jung MY, Shim JH, Lee JH, Lee JH, Yang JM, Lee DY, et al. Comparison of diagnostic methods for onychomycosis, and proposal of a diagnostic algorithm. Clin Exp Dermatol. 2015;40:479–84. Proposes a diagnostic algorithm for onychomycosis CrossRefPubMed • Jung MY, Shim JH, Lee JH, Lee JH, Yang JM, Lee DY, et al. Comparison of diagnostic methods for onychomycosis, and proposal of a diagnostic algorithm. Clin Exp Dermatol. 2015;40:479–84. Proposes a diagnostic algorithm for onychomycosis CrossRefPubMed
7.
Zurück zum Zitat Ohn J, Choe YS, Park J, Mun JH. Dermoscopic patterns of fungal melanonychia: Aa comparative study with other causes of melanonychia. J Am Acad Dermatol. 2017;76:488–93.CrossRefPubMed Ohn J, Choe YS, Park J, Mun JH. Dermoscopic patterns of fungal melanonychia: Aa comparative study with other causes of melanonychia. J Am Acad Dermatol. 2017;76:488–93.CrossRefPubMed
8.
Zurück zum Zitat Bet DL, Reis AL, Di Chiacchio N, Belda JW. Dermoscopy and Oonychomycosis: guided nail abrasion for mycological samples. An Bras Dermatol. 2015;90:904–6.CrossRefPubMedPubMedCentral Bet DL, Reis AL, Di Chiacchio N, Belda JW. Dermoscopy and Oonychomycosis: guided nail abrasion for mycological samples. An Bras Dermatol. 2015;90:904–6.CrossRefPubMedPubMedCentral
9.
Zurück zum Zitat Blake N, Zhu J, Hernandez G, Juliano PJ. A Rretrospective Rreview of Ddiagnostic Ttesting for Oonychomycosis of the Ffoot. J Am Podiatr Med Assoc. 2015;105:503–8.CrossRefPubMed Blake N, Zhu J, Hernandez G, Juliano PJ. A Rretrospective Rreview of Ddiagnostic Ttesting for Oonychomycosis of the Ffoot. J Am Podiatr Med Assoc. 2015;105:503–8.CrossRefPubMed
10.
Zurück zum Zitat Jeelani S, Ahmed QM, Lanker AM, Hassan I, Jeelani N, Fazili T. Histopathological examination of nail clippings using PAS staining (HPE-PAS): gold standard in diagnosis of Oonychomycosis. Mycoses. 2015;58:27–32.CrossRefPubMed Jeelani S, Ahmed QM, Lanker AM, Hassan I, Jeelani N, Fazili T. Histopathological examination of nail clippings using PAS staining (HPE-PAS): gold standard in diagnosis of Oonychomycosis. Mycoses. 2015;58:27–32.CrossRefPubMed
11.
Zurück zum Zitat Bombace F, Iovene MR, Galdiero M, Martora F, Nicoletti GF, D'’Andrea M, et al. Non-dermatophytic onychomycosis diagnostic criteria: an unresolved question. Mycoses. 2016;59:558–65.CrossRefPubMed Bombace F, Iovene MR, Galdiero M, Martora F, Nicoletti GF, D'’Andrea M, et al. Non-dermatophytic onychomycosis diagnostic criteria: an unresolved question. Mycoses. 2016;59:558–65.CrossRefPubMed
12.
Zurück zum Zitat Gomez-Moyano E, Erchiga VC, Martínez Pilar L, Godoy Diaz DJ. [Which is the role of cultures in the diagnosis of onychomycosis?]. Rev. Iberoam Micol. 2015;32:129–30.CrossRef Gomez-Moyano E, Erchiga VC, Martínez Pilar L, Godoy Diaz DJ. [Which is the role of cultures in the diagnosis of onychomycosis?]. Rev. Iberoam Micol. 2015;32:129–30.CrossRef
13.
Zurück zum Zitat Ovrén E, Berglund L, Nordlind K, Rollman O. Dermatophytosis: fluorostaining enhances speed and sensitivity in direct microscopy of skin, nail and hair specimens from dermatology outpatients. Mycoses. 2016;59:436–41.CrossRefPubMed Ovrén E, Berglund L, Nordlind K, Rollman O. Dermatophytosis: fluorostaining enhances speed and sensitivity in direct microscopy of skin, nail and hair specimens from dermatology outpatients. Mycoses. 2016;59:436–41.CrossRefPubMed
14.
Zurück zum Zitat •• Stephen S, Tosti A, Rubin AI. Diagnostic applications of nail clippings. Dermatol Clin. 2015;33:289–301. Highlights the applications and correct technique for obtaining nail clippings CrossRefPubMed •• Stephen S, Tosti A, Rubin AI. Diagnostic applications of nail clippings. Dermatol Clin. 2015;33:289–301. Highlights the applications and correct technique for obtaining nail clippings CrossRefPubMed
15.
Zurück zum Zitat Hajar T, Fernández-Martínez R, Moreno-Coutiño G, Vásquez Del Mercado E, Arenas R. Modified PAS stain: Aa new diagnostic method for onychomycosis. Rev. Iberoam Micol. 2016;33:34–7.CrossRefPubMed Hajar T, Fernández-Martínez R, Moreno-Coutiño G, Vásquez Del Mercado E, Arenas R. Modified PAS stain: Aa new diagnostic method for onychomycosis. Rev. Iberoam Micol. 2016;33:34–7.CrossRefPubMed
16.
Zurück zum Zitat Watanabe S, Ishida K. Molecular Ddiagnostic Ttechniques for Oonychomycosis: Vvalidity and Ppotential Aapplication. Am J Clin Dermatol. 2017;18:281–6.CrossRefPubMed Watanabe S, Ishida K. Molecular Ddiagnostic Ttechniques for Oonychomycosis: Vvalidity and Ppotential Aapplication. Am J Clin Dermatol. 2017;18:281–6.CrossRefPubMed
17.
Zurück zum Zitat •• Verrier J, Monod M. Diagnosis of Ddermatophytosis Uusing Mmolecular Bbiology. Mycopathologia. 2017;182:193–202. Comprehensive review of molecular diagnostic methods CrossRefPubMed •• Verrier J, Monod M. Diagnosis of Ddermatophytosis Uusing Mmolecular Bbiology. Mycopathologia. 2017;182:193–202. Comprehensive review of molecular diagnostic methods CrossRefPubMed
18.
Zurück zum Zitat Kotrotsiou T, Chatzimichaloglou A, Nasr A, Spandou E, Patsatsi A, Sotiriadis D, et al. A comparative study of three extraction protocols of DNA from nails: Ppotential use in the diagnosis of onychomycoses. Mycoses. 2017;60:183–7.CrossRefPubMed Kotrotsiou T, Chatzimichaloglou A, Nasr A, Spandou E, Patsatsi A, Sotiriadis D, et al. A comparative study of three extraction protocols of DNA from nails: Ppotential use in the diagnosis of onychomycoses. Mycoses. 2017;60:183–7.CrossRefPubMed
19.
Zurück zum Zitat Spiliopoulou A, Bartzavali C, Jelastopulu E, Anastassiou ED, Christofidou M. Evaluation of a commercial PCR test for the diagnosis of dermatophyte nail infections. J Med Microbiol. 2015;64(Pt 1):25–31.CrossRefPubMed Spiliopoulou A, Bartzavali C, Jelastopulu E, Anastassiou ED, Christofidou M. Evaluation of a commercial PCR test for the diagnosis of dermatophyte nail infections. J Med Microbiol. 2015;64(Pt 1):25–31.CrossRefPubMed
20.
Zurück zum Zitat Feng X, Ling B, Yang X, Liao W, Pan W, Yao Z. Molecular Iidentification of Ccandida Sspecies Iisolated from Oonychomycosis in Shanghai, China. Mycopathologia. 2015;180(5–6):365–71.CrossRefPubMed Feng X, Ling B, Yang X, Liao W, Pan W, Yao Z. Molecular Iidentification of Ccandida Sspecies Iisolated from Oonychomycosis in Shanghai, China. Mycopathologia. 2015;180(5–6):365–71.CrossRefPubMed
21.
Zurück zum Zitat Petinataud D, Berger S, Ferdynus C, Debourgogne A, Contet-Audonneau N, Machouart M. Optimising the diagnostic strategy for onychomycosis from sample collection to FUNGAL identification evaluation of a diagnostic kit for real-time PCR. Mycoses. 2016;59:304–11.CrossRefPubMed Petinataud D, Berger S, Ferdynus C, Debourgogne A, Contet-Audonneau N, Machouart M. Optimising the diagnostic strategy for onychomycosis from sample collection to FUNGAL identification evaluation of a diagnostic kit for real-time PCR. Mycoses. 2016;59:304–11.CrossRefPubMed
22.
Zurück zum Zitat Gong J, Ran M, Wang X, Wan Z, Li R. Development and Eevaluation of a Nnovel Rreal-Ttime PCR for Ppan-Ddermatophyte Ddetection in Nnail Sspecimens. Mycopathologia. 2016;181:51–7.CrossRefPubMed Gong J, Ran M, Wang X, Wan Z, Li R. Development and Eevaluation of a Nnovel Rreal-Ttime PCR for Ppan-Ddermatophyte Ddetection in Nnail Sspecimens. Mycopathologia. 2016;181:51–7.CrossRefPubMed
Metadaten
Titel
Onychomycosis Laboratory Diagnosis: Review
verfasst von
Jose Manuel Rios-Yuil
Publikationsdatum
08.07.2017
Verlag
Springer US
Erschienen in
Current Fungal Infection Reports / Ausgabe 3/2017
Print ISSN: 1936-3761
Elektronische ISSN: 1936-377X
DOI
https://doi.org/10.1007/s12281-017-0285-6

Weitere Artikel der Ausgabe 3/2017

Current Fungal Infection Reports 3/2017 Zur Ausgabe

Fungal Infections of Skin and Subcutaneous Tissue (A Bonifaz, Section Editor)

Fungal Paronychia. Clinical, Diagnosis and Treatment Aspects

Advances in Diagnosis of Invasive Fungal Infections (S Chen, Section Editor)

Sporotrichosis: Update on Diagnostic Techniques

Fungal Infections of Skin and Subcutaneous Tissue (A Bonifaz, Section Editor)

The Efficacy and Safety of Systemic Antifungals in Children’s Onychomycosis

Current Management of Fungal Infections (M Miceli, Section Editor)

Treatment of the Midwestern Endemic Mycoses, Blastomycosis and Histoplasmosis

Fungal Infections of Skin and Subcutaneous Tissue (A Bonifaz, Section Editor)

Fungal Leukonychia and Melanonychia: a Review

Leitlinien kompakt für die Innere Medizin

Mit medbee Pocketcards sicher entscheiden.

Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.