Nail sampling in onychomycosis: comparative study of curettage from three sites of the infected nail.
BACKGROUND
Onychomycosis is a common problem. Obtaining accurate laboratory test results before treatment is important in clinical practice since the treatment of onychomycosis requires expensive oral antifungal therapy with potentially serious side-effects. The purpose of this study was to compare results of curettage technique of nail sampling in the diagnosis of onychomycosis from three different sites of the affected nail to establish the best location of sampling.


METHODS
We evaluated 194 patients suffering from distal and lateral subungual onychomycosis (DLSO) and lateral subungual onychomycosis (LSO) using curettage technique. KOH examination and fungal culture were used for detection and identification of fungal infection.


RESULTS
The culture sensitivity improves significantly as the location of the sample is more proximal. Trichophyton rubrum was by far the most common pathogen detected from all sampling sites.


CONCLUSIONS
We found that the culture sensitivity improved as the location of the sample was more proximal. More types of pathogens were detected in samples taken from proximal parts of the affected nails.
Shemer
Avner
A
Department of Dermatology, Sheba Medical Center, Tel-Hashomer, Israel.
Trau
Henri
H
Davidovici
Batya
B
Grunwald
Marcelo H
MH
Amichai
Boaz
B
D000293:Adolescent; D000328:Adult; D000935:Antifungal Agents / Q000627:therapeutic use; D003475:Curettage; D005260:Female; D006801:Humans; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D009262:Nails / Q000382:microbiology / Q000473:pathology; D014009:Onychomycosis / Q000175:diagnosis / Q000188:drug therapy / Q000473:pathology*; D011237:Predictive Value of Tests; D014005:Tinea / Q000175:diagnosis / Q000188:drug therapy / Q000473:pathology; D014249:Trichophyton / Q000187:drug effects
D000935:Antifungal Agents