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Onychomycosis: An Analysis of 50 Cases and a Comparison of Diagnostic Techniques

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  • 1 Staff Pathologist, Parkway Regional Medical Center, Department of Pathology, 160 NW 170th St, North Miami Beach, FL 33169.
  • | 2 Staff Podiatrist, Parkway Regional Medical Center, Department of Surgery, North Miami Beach, FL.
  • | 3 Fellow, Ackerman Academy of Dermatopathology, New York, NY.
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Onychomycosis is an extremely common condition that is increasing in prevalence. Although often innocuous, it may be complicated by discomfort and secondary bacterial infections. Recently introduced oral medications may be highly effective in the eradication of this condition; however, they may carry with them significant expense and potentially serious side effects. Prior to the initiation of antifungal oral therapy, definitive diagnosis is mandatory. This study compares the sensitivity of potassium hydroxide (KOH) preparations, surgical pathology diagnostic testing (SPDT), and culture techniques for the detection of onychomycosis in 50 cases of clinically suspected onychomycosis. Analysis showed that SPDT was significantly more sensitive when compared to KOH and culture. The results suggest that SPDT may be the true gold standard for the diagnosis of onychomycosis. (J Am Podiatr Med Assoc 91(7): 351-355, 2001)