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2. Usefulness of histological examination for the diagnosis of onychomycosis

Author

C. Gianni, Manuela Papini, Patrizia Rossini, Paola Braidotti, Consuelo Greco, Amilcare Cerri, Antonio Guiducci, Roberta Calcaterra, and Valeria Morelli

Subjects
Adult, Male, medicine.medical_specialty, Pathology, Adolescent, Dermatology, Hand Dermatoses, Predictive Value of Tests, Onychomycosis, medicine, Humans, Fungal morphology, Child, Mycosis, Histological examination, Aged, Aged, 80 and over, Foot Dermatoses, business.industry, Direct microscopy, Fungi, nutritional and metabolic diseases, food and beverages, Middle Aged, medicine.disease, medicine.anatomical_structure, Nails, Nail disease, Predictive value of tests, Nail (anatomy), Female, business
Abstract

Background: Direct microscopy and culture tests currently used in the diagnosis of nail mycosis can yield false-negative results, and confirmation of the pathogenic agent, especially in non-dermatophyte infections, is often a lengthy process. Objective: The aim of this study was to investigate the usefulness of the histological examination of nail clipping samples in supplementing the standard microscopic and culture techniques for the diagnosis of onychomycosis. Patients and Methods: One hundred and seventy-two subjects affected by nail alterations suggestive of onychomycosis were evaluated. Nail specimens were studied with 3 different techniques: direct microscopic examination of a 40% KOH clarified preparation, fungal culture and histological examination. Patients positive for fungal infection were re-evaluated with the same techniques after treatment with oral terbinafine, fluconazole or itraconazole and topical application of bifonazole or ciclopirox for 2 months. Results: Direct microscopy was positive in 102 (59.3%) nail specimens. The culture test was positive in 90 cases (52.9%), showing a dermatophyte in 45, a yeast in 23 and a mould in 22 samples. The histological examination was positive in 94 (54.6%) samples. In 4 cases, it was the only investigation confirming the clinical diagnosis of nail mycosis. In most of the cases, the morphological aspect of the hyphae and/or spores suggested also to which group of pathogens (dermatophytes, yeasts or moulds) the mycetes observed in the histological sections could be ascribed. The concurrent presence of a dermatophyte and a mould was evidenced in a few specimens. The control histological examination at the end of the treatment showed negative results or residual non-vital hyphae and/or spores. Conclusions: Results of the present study indicate that the histological examination of nail clipping specimens is a relatively inexpensive, rapid and easily performed procedure. It is useful to confirm or refute the results of routine microscopy and culture tests. Moreover, nail histopathological observation may help in ascribing a pathogenic role of non-dermatophyte isolates and evaluating the effectiveness of antifungal treatment.

Published
2001

3. Subject Index Vol. 202, 2001

Author

B. Hermes, S. Kawana, W.H.C. Burgdorf, B Lecewicz-Toruń, Kristien De Paepe, T. Takano, Vera Rogiers, Diane Roseeuw, C. Gianni, Konstantine Buxtorf, K. Nomura, Consuelo Greco, Jean-Pierre Hachem, B.M. Henz, K.H. Holubar, M. Harms, Robert Baran, C. Hildenbrand, Francesco Drago, Phung M. Huynh, Y. Kimura, S. Läuchli, Paolo Rampini, Ulrich Binswanger, K. Suzuki, J. Brinckmann, Aldona Pietrzak, Jean-Hilaire Saurat, N. Zakopoulou, Amilcare Cerri, Jong-Sub Moon, Eugen Hübscher, Frank O. Nestle, Leonard Kaufman, Michael Meurer, M. Alexander, Manuela Papini, Naveed Sami, Mariateresa Semino, Gurvinder P. Thami, G.L. Vecchietti, Roberta Calcaterra, Antonio Guiducci, Magali Berset, P. Chavaz, A. Razzaque Ahmed, J.P. Cerottini, Paola Braidotti, J. Fäh, A.M. Matta, A. Friedli, Sukhjot Kaur, C. Tschanz, Jürg Hafner, Gürkan Kaya, F. Livio, L. Widmer, Rudolf Happle, A. Matsuyama, Dorota Krasowska, Amrinder J. Kanwar, M. Aoki, Alfred Eichmann, Jean L. Bolognia, W. Löntz, S. Takezaki, A. Hürlimann, T. Tuchida, Els Vanpée, N. Haas, Somesh Gupta, K. Buxtorf, Valeria Morelli, Christa Prins, P. Agache, Günther F.L. Hofbauer, S. Lautenschlager, S. Mary, M. Mock, G.J. Kontochristopoulos, Enrico Rampini, P. Muret, P. Humbert, M. Derighetti, I. Masouyé, Reinhard Dummer, E. Holle, M. Streit, Patrizia Rossini, R.G. Panizzon, Y. Kikuchi, Rossitza Lazova, Chil-Hwan Oh, Werner Kempf, A. Skaria, Anne-Kathrin Tausche, L.M. Böhlen, D. Salomon, Severin Läuchli, R.M. Trüeb, M. Tronnier, L.R. Braathen, E.C. Alexandropoulos, Günter Burg, and Renato G. Panizzon

Subjects
Index (economics), Statistics, Subject (documents), Dermatology, Mathematics
Published
2001
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4. Contents Vol. 202, 2001

Author

P. Humbert, I. Masouyé, Naveed Sami, Günther F.L. Hofbauer, S. Lautenschlager, L. Widmer, A.M. Matta, Gürkan Kaya, C. Gianni, E. Holle, Christa Prins, L.M. Böhlen, Dorota Krasowska, Vera Rogiers, L.R. Braathen, Kristien De Paepe, Consuelo Greco, T. Takano, Aldona Pietrzak, Somesh Gupta, Anne-Kathrin Tausche, Leonard Kaufman, Paolo Rampini, S. Kawana, P. Agache, Paola Braidotti, K. Suzuki, J.P. Cerottini, C. Hildenbrand, Jean-Pierre Hachem, C. Tschanz, Jürg Hafner, Y. Kimura, W. Löntz, Michael Meurer, Amilcare Cerri, Gurvinder P. Thami, Phung M. Huynh, S. Mary, Antonio Guiducci, Els Vanpee, M. Harms, B. Hermes, B.M. Henz, N. Zakopoulou, Eugen Hübscher, J. Brinckmann, G.J. Kontochristopoulos, Sukhjot Kaur, M. Aoki, Severin Läuchli, K. Buxtorf, Alfred Eichmann, Jean L. Bolognia, M. Alexander, Manuela Papini, W.H.C. Burgdorf, B Lecewicz-Toruń, N. Haas, Diane Roseeuw, M. Derighetti, G.L. Vecchietti, S. Takezaki, Robert Baran, Rudolf Happle, Magali Berset, S. Läuchli, Jean-Hilaire Saurat, Roberta Calcaterra, Ulrich Binswanger, Jong-Sub Moon, Frank O. Nestle, Reinhard Dummer, Patrizia Rossini, Mariateresa Semino, F. Livio, D. Salomon, Francesco Drago, T. Tuchida, Y. Kikuchi, Rossitza Lazova, Chil-Hwan Oh, Enrico Rampini, Renato G. Panizzon, A. Skaria, Werner Kempf, Konstantine Buxtorf, K. Nomura, Amrinder J. Kanwar, P. Chavaz, Valeria Morelli, A. Friedli, E.C. Alexandropoulos, R.G. Panizzon, M. Streit, M. Mock, P. Muret, R.M. Trüeb, M. Tronnier, A. Razzaque Ahmed, J. Fäh, K.H. Holubar, A. Matsuyama, A. Hürlimann, and Günter Burg

Subjects
Dermatology
Published
2001
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