A Comparative Study for Diagnosing Onychomycosis Using KOH Smear, Fungal Culture, KONCPA and Fungi-Fluor(R) Stain / 대한의진균학회지

ABSTRACT

BACKGROUND: Onychomycosis is common nail problem and requires administration of antifungal agent for long period. But several cutaneous diseases can produce similar nail changes and an inexpensive, quick and sensitive test is essential for screening nail specimens. Recently, there have been several reports of new method for diagnosing onychomycosis and fungi-Fluor(R)stain, which had been used to detect fungal elements in the tissue, was not used for diagnosing onychomycosis. OBJECTIVE: This study was undertaken to evaluate the usefulness of the new method using Fungi-Fluor(R)solution for the diagnosis of onychomycosis, and compare with other methods. METHODS: During the study period, nail samples obtained from 72 patients with onychomycosis were tested for Fungi-Fluor(R)solution and the results of that were compared with those of KOH smear, fungal culture and KONCPA test. RESULTS: The results of this study are summarized as follows 1. The positive rates of conventional KOH nail scraping preparation, fungal culture, KONCPA and Fungi-Fluor(R)staining were 47.2%,40.3%, 77.8%, and 86.1%, respectively. 2. Fungi-Fluor(R)staining proved to be less time-consuming than KONCPA test. 3. Compared to KONCPA and Fungi-Fluor(R)staining, KOH preparation and fungal culture showed high false positive rate. 4. Though both KONCPA and Fungi-Fluor(R)staining showed higher positive rate in toenail than fingernail, there were no statistic significance. CONCLUSION: The Fungi-Fluor(R)solution staining is rapid, inexpensive, and highly sensitive method to detect fungal elements in the nails.