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Dermoscopic patterns in patients with a clinical diagnosis of onychomycosis—results of a prospective study including data of potassium hydroxide (KOH) and culture examination

BACKGROUND: Onychomycosis is the most common nail disease, representing 50% of cases affecting the nail apparatus. The diagnosis is made by clinical examination along with the KOH exam of the nail and culture of the sample. However, not all dermatologists have access to a mycology lab. OBJECTIVE: To...

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Autores principales: Jesús-Silva, Miriam América, Fernández-Martínez, Ramón, Roldán-Marín, Rodrigo, Arenas, Roberto
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Derm101.com 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4462897/
https://www.ncbi.nlm.nih.gov/pubmed/26114050
http://dx.doi.org/10.5826/dpc.0502a05
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author Jesús-Silva, Miriam América
Fernández-Martínez, Ramón
Roldán-Marín, Rodrigo
Arenas, Roberto
author_facet Jesús-Silva, Miriam América
Fernández-Martínez, Ramón
Roldán-Marín, Rodrigo
Arenas, Roberto
author_sort Jesús-Silva, Miriam América
collection PubMed
description BACKGROUND: Onychomycosis is the most common nail disease, representing 50% of cases affecting the nail apparatus. The diagnosis is made by clinical examination along with the KOH exam of the nail and culture of the sample. However, not all dermatologists have access to a mycology lab. OBJECTIVE: To determine the correlation between KOH examination and dermoscopic patterns in patients with clinical diagnosis of onychomycosis. PATIENTS/METHODS: A descriptive, open, observational, prospective, cross-sectional study of 178 patients with clinical suspicion of onychomycosis was conducted. All patients underwent clinical examination, dermoscopy with a DermLite PHOTO dermatoscope (3Gen, San Juan Capistrano, CA, USA), KOH assessment and culture analysis. The most frequent dermoscopic patterns were identified and their correlation with the clinical subtype of onychomycosis was analyzed. RESULTS: The study included 178 patients with clinical suspicion of onychomycosis. Of these, 155 (87.1%) had positive direct KOH examination for onychomycosis. Eighty-seven patients (56.13%) presented with clinical onychomycosis pattern of total dystrophic onychomycosis (TDO), 67 (43.23%) with distal lateral subungual onychomycosis (DLSO), 1 (0.65%) with trachyonychia). Dermoscopic patterns of onychomycosis showed the following frequencies: the spiked pattern was present in 22 patients (14.19%), longitudinal striae pattern in 51 patients (32.9%) and linear edge pattern in 21 patients (13.55%). We identified a pattern described as “distal irregular termination” in 41 patients with TDO and 26 with DLSO. CONCLUSIONS: This is the fist study conducted in a Mexican population that uses dermoscopy as a diagnostic tool along with the KOH examination for the diagnosis of onychomycosis. Dermoscopy may be used as an important diagnostic tool when evaluating nail disease. However, it should not be used as the only diagnostic criteria for onychomycosis.
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spelling pubmed-44628972015-06-25 Dermoscopic patterns in patients with a clinical diagnosis of onychomycosis—results of a prospective study including data of potassium hydroxide (KOH) and culture examination Jesús-Silva, Miriam América Fernández-Martínez, Ramón Roldán-Marín, Rodrigo Arenas, Roberto Dermatol Pract Concept Research BACKGROUND: Onychomycosis is the most common nail disease, representing 50% of cases affecting the nail apparatus. The diagnosis is made by clinical examination along with the KOH exam of the nail and culture of the sample. However, not all dermatologists have access to a mycology lab. OBJECTIVE: To determine the correlation between KOH examination and dermoscopic patterns in patients with clinical diagnosis of onychomycosis. PATIENTS/METHODS: A descriptive, open, observational, prospective, cross-sectional study of 178 patients with clinical suspicion of onychomycosis was conducted. All patients underwent clinical examination, dermoscopy with a DermLite PHOTO dermatoscope (3Gen, San Juan Capistrano, CA, USA), KOH assessment and culture analysis. The most frequent dermoscopic patterns were identified and their correlation with the clinical subtype of onychomycosis was analyzed. RESULTS: The study included 178 patients with clinical suspicion of onychomycosis. Of these, 155 (87.1%) had positive direct KOH examination for onychomycosis. Eighty-seven patients (56.13%) presented with clinical onychomycosis pattern of total dystrophic onychomycosis (TDO), 67 (43.23%) with distal lateral subungual onychomycosis (DLSO), 1 (0.65%) with trachyonychia). Dermoscopic patterns of onychomycosis showed the following frequencies: the spiked pattern was present in 22 patients (14.19%), longitudinal striae pattern in 51 patients (32.9%) and linear edge pattern in 21 patients (13.55%). We identified a pattern described as “distal irregular termination” in 41 patients with TDO and 26 with DLSO. CONCLUSIONS: This is the fist study conducted in a Mexican population that uses dermoscopy as a diagnostic tool along with the KOH examination for the diagnosis of onychomycosis. Dermoscopy may be used as an important diagnostic tool when evaluating nail disease. However, it should not be used as the only diagnostic criteria for onychomycosis. Derm101.com 2015-04-30 /pmc/articles/PMC4462897/ /pubmed/26114050 http://dx.doi.org/10.5826/dpc.0502a05 Text en Copyright: © 2015 Jesús-Silva et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research
Jesús-Silva, Miriam América
Fernández-Martínez, Ramón
Roldán-Marín, Rodrigo
Arenas, Roberto
Dermoscopic patterns in patients with a clinical diagnosis of onychomycosis—results of a prospective study including data of potassium hydroxide (KOH) and culture examination
title Dermoscopic patterns in patients with a clinical diagnosis of onychomycosis—results of a prospective study including data of potassium hydroxide (KOH) and culture examination
title_full Dermoscopic patterns in patients with a clinical diagnosis of onychomycosis—results of a prospective study including data of potassium hydroxide (KOH) and culture examination
title_fullStr Dermoscopic patterns in patients with a clinical diagnosis of onychomycosis—results of a prospective study including data of potassium hydroxide (KOH) and culture examination
title_full_unstemmed Dermoscopic patterns in patients with a clinical diagnosis of onychomycosis—results of a prospective study including data of potassium hydroxide (KOH) and culture examination
title_short Dermoscopic patterns in patients with a clinical diagnosis of onychomycosis—results of a prospective study including data of potassium hydroxide (KOH) and culture examination
title_sort dermoscopic patterns in patients with a clinical diagnosis of onychomycosis—results of a prospective study including data of potassium hydroxide (koh) and culture examination
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4462897/
https://www.ncbi.nlm.nih.gov/pubmed/26114050
http://dx.doi.org/10.5826/dpc.0502a05
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