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• W2146805536 abstract "Objective: Several tests are currently used for diagnosis of onychomycosis and many health insurers are requiring the documentation of a positive laboratory test prior to approving payment of treatment for onychomycosis. The purpose of this study was to determine which of the following seven tests is the most sensitive for confirming the diagnosis of toenail onychomycosis: 20% potassium hydroxide (KOH) preparation (interpreted separately by a dermatologist and a mycologist); KOH enhanced preparation with Chlorazol Black E; KOH preparation with dimethylsulfoxide (DMSO); culture on Dermatophyte Test Medium (DTM); culture on Mycosel; and histological examination with Periodic-acid Schiff staining (PAS). Methodology: Volunteers with at least one dystrophic toenail were recruited from the Minneapolis Veterans Affairs Medical Center. After informed consent was obtained, a clinical nail exam was performed, subungual debris from all clinically affected toenails was collected with a 1 millimeter curette for KOH and cultures, and distal nail clippings were collected for histopathological examination. If fingernails were involved, specimens were collected separately using the same methodology. All KOH preparations were read by a board certified dermatologist (EW), who was blinded to specimen origin. In addition, a KOH preparation, as well as culture, was performed by hospital mycologists. PAS staining was interpreted by board certified pathologists. The sensitivity of each test was determined by dividing the number of specimens with positive results for a specific test by the number of specimens with at least one positive result from any of the seven tests. Cost analyses were performed from a VA and societal perspective. Results: Two hundred and six volunteers participated in this study. Most were male and over the age of 50. Fingernail involvement was present in 7.7%. Data on sensitivity of diagnostic tests and cost analyses will be presented. This study was supported by a Minnesota Medical Foundation Medical Student Research Grant. It was also supported by the Minneapolis Veterans Affairs Medical Center and its Center of Excellence on Chronic Disease Outcomes Research." @default.
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• W2146805536 date "2004-03-01" @default.
• W2146805536 modified "2023-09-27" @default.
• W2146805536 title "Sensitivity and cost-effectiveness of diagnostic tests for onychomycosis" @default.
• W2146805536 doi "https://doi.org/10.1016/j.jaad.2003.10.335" @default.
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