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1Mycology Laboratory, St. Louis Hospital, 1 Avenue Claude Vellefaux, 75475 Paris Cedex, France. martinefeuilhade@yahoo.fr
Summary
Accurate onychomycosis diagnosis is crucial for effective treatment. Mycological examination, combining microscopy and culture, remains the most informative and cost-effective method for identifying fungal pathogens.
Area of Science:
- Medical Mycology
- Diagnostic Microbiology
Background:
- Onychomycosis diagnosis requires pathogen identification for optimal treatment.
- Current diagnostic methods vary in efficacy and accessibility.
Purpose of the Study:
- To review current diagnostic strategies for onychomycosis.
- To evaluate alternative diagnostic techniques.
Main Methods:
- Review of mycological examination (potassium hydroxide microscopy and culture).
- Assessment of histological analysis, in vivo confocal microscopy, flow cytometry, and molecular methods (PCR, PCR-RFLP).
Main Results:
- Mycological examination is the most common technique, requiring microscopy and culture for species identification.
- Histological analysis is efficient but not optimal for culture.
- Advanced techniques like confocal microscopy, flow cytometry, and PCR-based methods are costly and complex.
- PCR-RFLP is suitable for patients on antifungals but requires skilled staff.
Conclusions:
- Mycological examination (microscopy and culture) is the gold standard for onychomycosis diagnosis.
- It offers the most comprehensive information at a reasonable cost and with minimal patient inconvenience.