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What is the best method of diagnosing onychomycosis?
PRACTICE RECOMMENDATIONS

Nail plate biopsy followed by periodic acid–Schiff staining is the most accurate method for diagnosing onychomycosis. The positive predictive value (PV+) of periodic acid–Schiff staining was equal to both potassium hydroxide (KOH) preparation and fungal culture, with a greater negative predictive value (PV–) due to superior sensitivity.

However, availability of periodic acid–Schiff staining may vary geographically, and the cost of the diagnostic tests is not addressed in this study. Thus, it makes clinical sense to start with the most accessible test, using periodic acid–Schiff staining if other methods are negative and clinical suspicion is high.

 
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Practice Recommendations from Key Studies

Weinberg JM, Koestenblatt EK, Tutrone WD, Tishler HR, Najarian L. Comparison of diagnostic methods in the evaluation of onychomycosis. J Am Acad Dermatol 2003; 49:193–197.

Cathy Rea, MD
Mark H. Greenawald, MD
Department of Family Practice, Carilion Health System, Roanoke, Va. E-mail: [email protected].

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The Journal of Family Practice - 52(12)
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Practice Recommendations from Key Studies

Weinberg JM, Koestenblatt EK, Tutrone WD, Tishler HR, Najarian L. Comparison of diagnostic methods in the evaluation of onychomycosis. J Am Acad Dermatol 2003; 49:193–197.

Cathy Rea, MD
Mark H. Greenawald, MD
Department of Family Practice, Carilion Health System, Roanoke, Va. E-mail: [email protected].

Author and Disclosure Information

Practice Recommendations from Key Studies

Weinberg JM, Koestenblatt EK, Tutrone WD, Tishler HR, Najarian L. Comparison of diagnostic methods in the evaluation of onychomycosis. J Am Acad Dermatol 2003; 49:193–197.

Cathy Rea, MD
Mark H. Greenawald, MD
Department of Family Practice, Carilion Health System, Roanoke, Va. E-mail: [email protected].

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PRACTICE RECOMMENDATIONS

Nail plate biopsy followed by periodic acid–Schiff staining is the most accurate method for diagnosing onychomycosis. The positive predictive value (PV+) of periodic acid–Schiff staining was equal to both potassium hydroxide (KOH) preparation and fungal culture, with a greater negative predictive value (PV–) due to superior sensitivity.

However, availability of periodic acid–Schiff staining may vary geographically, and the cost of the diagnostic tests is not addressed in this study. Thus, it makes clinical sense to start with the most accessible test, using periodic acid–Schiff staining if other methods are negative and clinical suspicion is high.

 
PRACTICE RECOMMENDATIONS

Nail plate biopsy followed by periodic acid–Schiff staining is the most accurate method for diagnosing onychomycosis. The positive predictive value (PV+) of periodic acid–Schiff staining was equal to both potassium hydroxide (KOH) preparation and fungal culture, with a greater negative predictive value (PV–) due to superior sensitivity.

However, availability of periodic acid–Schiff staining may vary geographically, and the cost of the diagnostic tests is not addressed in this study. Thus, it makes clinical sense to start with the most accessible test, using periodic acid–Schiff staining if other methods are negative and clinical suspicion is high.

 
Issue
The Journal of Family Practice - 52(12)
Issue
The Journal of Family Practice - 52(12)
Page Number
919-941
Page Number
919-941
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What is the best method of diagnosing onychomycosis?
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