title: Screening for tinea unguium by Dermatophyte Test Strip.
abstract: BACKGROUND
  The direct microscopy, fungal culture and histopathology that are necessary for the definitive diagnosis of tinea unguium are disadvantageous in that detection sensitivity is affected by the level of skill of the person who performs the testing, and the procedures take a long time.
  
  
  OBJECTIVE
  The Dermatophyte Test Strip, which was developed recently, can simply and easily detect filamentous fungi in samples in a short time, and there are expectations for its use as a method for tinea unguium screening. With this in mind, we examined the detection capacity of the Dermatophyte Test Strip for tinea unguium.
  
  
  METHODS
  The presence or absence of fungal elements was judged by direct microscopy and Dermatophyte Test Strip in 165 nail samples obtained from residents in nursing homes for the elderly. Moreover, the minimum sample amount required for positive determination was estimated using 32 samples that showed positive results by Dermatophyte Test Strip.
  
  
  RESULTS
  The Dermatophyte Test Strip showed 98% sensitivity, 78% specificity, 84·8% positive predictive value, 97% negative predictive value and a positive and negative concordance rate of 89·1%. The minimum sample amount required for positive determination was 0·002-0·722 mg.
  
  
  CONCLUSIONS
  The Dermatophyte Test Strip showed very high sensitivity and negative predictive value, and was considered a potentially useful method for tinea unguium screening. Positive determination was considered to be possible with a sample amount of about 1 mg.
authors.affiliation: Department of Dermatology, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Tsunemi
authors.forename: K
authors.initials: K
authors.lastname: Takehara
authors.forename: Y
authors.initials: Y
authors.lastname: Miura
authors.forename: G
authors.initials: G
authors.lastname: Nakagami
authors.forename: H
authors.initials: H
authors.lastname: Sanada
authors.forename: M
authors.initials: M
authors.lastname: Kawashima
mesh_terms: D006801:Humans; D009262:Nails / Q000382:microbiology; D011934:Reagent Strips; D012680:Sensitivity and Specificity; D014005:Tinea / Q000175:diagnosis*
chemical_list: D011934:Reagent Strips