Nail Clipping with PAS Stain and Correlation with Fungi Isolated in Culture: A Valuable Exchange in the Diagnosis of Onychomycosis

Pathology - Research Article

Trevisan F.a· Veasey J.V.b· Werner B.c

Author affiliations

aMedical Clinic Department, Hospital of Clinics, Federal University of Paraná, Curitiba, Brazil
bDermatology Department, Clinic of Dermatology, Santa Casa de Sao Paulo School of Medical Sciences, São Paulo, Brazil
cMedical Pathology Department, Hospital of Clinics, Federal University of Paraná, Curitiba, Brazil

Log in to MyKarger to check if you already have access to this content.

Buy FullText & PDF Unlimited re-access via MyKarger Unrestricted printing, no saving restrictions for personal use
read more

CHF 38.00 *
EUR 35.00 *
USD 39.00 *

Select

KAB

Buy a Karger Article Bundle (KAB) and profit from a discount!

If you would like to redeem your KAB credit, please log in.

Save over 20% compared to the individual article price.

Learn more

Rent/Cloud Rent for 48h to view Buy Cloud Access for unlimited viewing via different devices Synchronizing in the ReadCube Cloud Printing and saving restrictions apply Rental: USD 8.50
Cloud: USD 20.00

Select

Subscribe Access to all articles of the subscribed year(s) guaranteed for 5 years Unlimited re-access via Subscriber Login or MyKarger Unrestricted printing, no saving restrictions for personal use read more

Subcription rates

Select

* The final prices may differ from the prices shown due to specifics of VAT rules.

Article / Publication Details

First-Page Preview

Abstract of Pathology - Research Article

Received: November 28, 2021
Accepted: February 25, 2022
Published online: May 05, 2022

Number of Print Pages: 7
Number of Figures: 5
Number of Tables: 1

ISSN: 2296-9195 (Print)
eISSN: 2296-9160 (Online)

For additional information: https://www.karger.com/SAD

Abstract

Introduction: The etiological agents of onychomycosis are dermatophyte fungi, nondermatophyte filamentous fungi (NDFF), and yeasts. Nail clippings are an accurate tool for diagnosing onychomycosis. The objective of this study was to correlate the characteristics of fungi observed in nail clipping examinations with the results for agents isolated in culture, indicating whether the fungus found on microscopy is a dermatophyte, NDFF, or yeast. Methods: An observational descriptive study of onychomycosis nail clippings stained with PAS comparing culture results with microscopic criteria of fungi morphology, arrangement/orientation, and location of organisms in the nail and presence of neutrophils, serous lakes, and bacterial colonies was conducted. Results: Thirty-three nail clippings from 29 participants were analyzed. A statistically significant correlation (p < 0.05) was found between smooth/thin/long hyphae with a “combed” pattern and dermatophyte agents (sensitivity 89.4%, specificity 91.5%), and between irregular/thick/short anarchic distributed hyphae and nondermatophytes (sensitivity 61.5%, specificity 89.4%). No statistical association with region where fungi were in the nail or with the presence of neutrophils, serous lakes or bacteria was found. Small, rounded, yeast-like organisms correlated with Candida infection. Conclusions: Although not a substitute for culture, microscopic analysis of fungal structures offers good accuracy for differentiating agents of onychomycosis.

© 2022 S. Karger AG, Basel

References Cribier BJ, Paul C. Long-term efficacy of antifungals in toenail onychomycosis: a critical review. Br J Dermatol. 2001;145(3):446–52. Ebihara M, Makimura K, Sato K, Abe S, Tsuboi R. Molecular detection of dermatophytes and nondermatophytes in onychomycosis by nested polymerase chain reaction based on 28S ribosomal RNA gene sequences. Br J Dermatol. 2009;161(5):1038–44. Lipner SR, Scher RK. Onychomycosis: clinical overview and diagnosis. J Am Acad Dermatol. 2019;80(4):835–51. Veasey JV, Nappi F, Zaitz C, Muramatu LH. Descriptive analysis of mycological examination of patients with onychomycosis treated in private practice. An Bras Dermatol. 2017;92(1):134–6. Leung AKC, Lam JM, Leong KF, Hon KL, Barankin B, Leung AAM, et al. Onychomycosis: an updated review. Recent Pat Inflamm Allergy Drug Discov. 2020;14(1):32–45. Lecerf P, Abdy S, Vollono L, Pastushenko I, Richert B, André J. Direct examination, histopathology and fungal culture for the diagnosis of onychomycosis: a retrospective, comparative study on 2245 specimens. Mycoses. 2021;64(2):187–93. Werner B, Antunes A. Microscopic examination of normal nail clippings. Dermatol Pract Concept. 2013;3:9–14. Veasey JV, Meneses OMS, da Silva FO. Reflectance confocal microscopy of tinea capitis: comparing images with results of dermoscopy and mycological exams. Int J Dermatol. 2019;58(7):849–51. Veasey JV, Avila RB, Ferreira MAMO, Lazzarini R. Reflectance confocal microscopy of tinea nigra: comparing images with dermoscopy and mycological examination results. An Bras Dermatol. 2017;92(4):568–9. Veasey JV, Framil VM, Nadal SR, Marta AC, Lellis RF. Genital warts: comparing clinical findings to dermatoscopic aspects, in vivo reflectance confocal features and histopathologic exam. An Bras Dermatol. 2014;89(1):137–40. Kayarkatte MN, Singal A, Pandhi D, Das S, Sharma S. Nail dermoscopy (onychoscopy) findings in the diagnosis of primary onychomycosis: a Cross-Sectional Study. Indian J Dermatol Venereol Leprol. 2020;86(4):341–9. Celestrino GA, Veasey JV, Benard G, Sousa MGT. Host immune responses in dermatophytes infection. Mycoses. 2021;64(5):477–83. Trevisan F, Werner B, Pinheiro RL. Nail clipping in onychomycosis and comparison with normal nails and ungual psoriasis. An Bras Dermatol. 2019;94(3):344–7. Werner B, Fonseca GP, Seidel G. Microscopic nail clipping findings in patients with psoriasis. Am J Dermatopathol. 2015;37:429–39. Article / Publication Details

First-Page Preview

Abstract of Pathology - Research Article

Received: November 28, 2021
Accepted: February 25, 2022
Published online: May 05, 2022

Number of Print Pages: 7
Number of Figures: 5
Number of Tables: 1

ISSN: 2296-9195 (Print)
eISSN: 2296-9160 (Online)

For additional information: https://www.karger.com/SAD

Copyright / Drug Dosage / Disclaimer Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

留言 (0)

沒有登入
gif