title: A nail drilling method suitable for the diagnosis of onychomycosis.
abstract: We describe a nail drilling method suitable for the diagnosis of onychomycosis. Thirty-three patients with onychomycosis in which the big toenail had a white band or spike were enrolled in this study. We drilled a hole about 3-mm-wide in the most proximal part of the white band or spike using a ball-shaped metal file and then, through the hole, sampled the underlying nail material softened by fungi after removing the superficial hard nail plate. Fungi in 32 (97.0%) of the nail samples were detected by direct KOH examination. When incubated on Sabouraud's dextrose agar slant with chloramphenicol and cycloheximide, fungal cultures were obtained from 27 (81.8%) of the 33 nail samples. Fourteen of the fungal isolates were identified as T. rubrum, 11 as T. mentagrophytes, and 2 as Acremonium sp. The nail drilling method is suitable for diagnosing onychomycosis with a white band or spike, because it gives a high isolation rate and leaves the patients' nail relatively more intact compared with other methods.
authors.affiliation: Department of Dermatology, Kanazawa Medical University, Daigaku 1-1, Uchinada, Ishikawa 920-0293, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Mochizuki
authors.forename: Masako
authors.initials: M
authors.lastname: Kawasaki
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Tanabe
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Ishizaki
mesh_terms: D000164:Acremonium / Q000302:isolation & purification; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy / Q000295:instrumentation*; D005260:Female; D005533:Foot Dermatoses / Q000175:diagnosis* / Q000473:pathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009262:Nails / Q000473:pathology*; D014009:Onychomycosis / Q000175:diagnosis* / Q000473:pathology; D011237:Predictive Value of Tests; D014249:Trichophyton / Q000302:isolation & purification