Nail fungus diagnosis, PATHPAS is the best method?
Best method for nail fungus diagnosis must be done because clearly nail fungus is not the only cause of nail disease, although it is the most common cause. Psoriasis, eczema and nail trauma may also mimic the symptoms of nail fungus. Cancer, although uncommon, may be difficult to differentiate from onychomycosis, especially when only a single nail is affected.
Onychomycosis is common, affecting 2% to 18% of the general population. Increasing public awareness and the number of new treatments available make an efficient diagnostic strategy with good sensitivity even more needed. At present, clinicians rely on clinical examination and a combination of direct microscopy and fungal culture (KONCPA method) to achieve a diagnosis for toenail fungus. These diagnostic methods are not only need more time but they may be technically difficult even when performed by experienced hands. High-quality data on sensitivity of direct microscopy performed by experienced operators are lacking. Fungal cultures are not highly sensitive or specific. For these reasons, many clinicians are not confirming the diagnosis of onychomycosis before treatment. New antifungal drugs are more effective and safer than previous nail fungus treatments, but are relatively expensive and have recognized risks. An accurate diagnostic strategy is needed to confirm the diagnosis of toenail fungus infections.
Above problem is making some researchers think about the diagnostic method which is more accurate than the KONCPA method. Finally, the researchers conducted a study to compare two methods for the diagnosis of nail fungus, KONCPA methods and PATHPAS methods. 63 patients consisted of 34 male patients and 29 women were included in this study. From 63 patients, 54 of whom suffer from toenail fungus and the rest suffered from fungal infections on fingernails. From the results of these studies we found that a single method using PATHPAS have a higher sensitivity than the other single method. PATHPAS combining with the culture technique can indeed be more sensitive in diagnosing nail fungus, but the increase was not statistically significant. However, PATHPAS method also has weaknesses. The PATHPAS test fails to identify the species of the fungal Organism. This is probably not clinically significant unless the Organism is a nondermatophyte agent that may be resistant to certain drugs.
So what can we conclude from these results?
The PATHPAS method appears to be the single most sensitive method for diagnosing nail fungus. It is easily performed and not cause trauma. We also can see the results of this PATHPAS method quickly. Although PATHPAS appears to be the best single method for diagnosing onychomycosis, it is clearly not acceptable as a gold standard. Further study is needed to determine the sensitivity of PATHPAS plus fungal cultures obtained by combined sampling methods (clipping, subungual curettage, and nail plate shaving). This may allow for the development of a highly sensitive and efficient method for diagnosing onychomycosis.
Reference:
Monica A. Lawry, MD, et al. Methods for Diagnosing Onychomycosis : A Comparative Study and Review of the Literature. 2000. American Medical Association.
Top 10 Natural Remedies for Nail Fungus
Sometimes, we need natural remedies for reliefing symptoms of nail fungus such as deformed nails, nails that thicken at the ends, loose skin, the appearance of foreign tissue between the nail and the skin nails yellow or brownish.
The fungal infections can occur in both toenails and fingernails, you may previously have been itching in the fingers that could have been cured or not before the nails start to have these signs.
Toenail fungus are difficult to control and treatment, even cured nail infection will continue to be wrong until you have grown back healthy from nails bed, this period can be months or a year. This is important to know because sometimes the treatments are stopped by not observing immediate results, all medical treatments or home remedies should be continued for extended periods.
These are 10 natural remedies to fight against nail fungus More »
Tea Tree Oil Proven In Treating Toenail Fungus
Tea tree oil is believed to be used for treating toenail fungus safe and fast. 
Long times ago, Tea tree oil has long been used in Aboriginal natural medicine of New South Wales and Australia as home remedies for wounds and skin infections. And now, people are interested in studying how natural products can work in curing skin infections, including nail fungal infections. This natural remedy for yeast infection contains active substances Terpinen-4-ol and 1,8-cineole which can inhibit fungal growth.
A recent study has shown that tea tree oil effective for treating yeast infections. The study, published in 2003 that examined the work tea tree oil to heal the human pathogenic yeast that is resistant to oral treatment such as fluconazole and itraconazole (sporanox).
The study published in the Journal of Antimicrobial Chemotherapy aims to prove the anti-fungal activity of tea tree oil against Candida albicans in mice suffering from vaginal candidiasis. The result is tea tree oil can inhibit the growth of fungi that are resistant to fluconazole and itraconazole. Here again, the fungal infection was resolved in 3 weeks by tea tree oil, whereas all other animals, either untreated or treated with fluconazole, were still suffering yeast infection.
Seeing the results of this study, the use of tea tree oil for toenail fungus natural remedies is more reliable. This natural treatment can be used as an alternative treatment if fluconazole was not able to relief toenail fungus. Overall, further research on tea tree oil is needed to further prove the effect of this natural remedy against Trichophyton rubrum, the most common fungal cause toenail fungus.
Reference:
Francesca Mondello1, et al. In vitro and in vivo activity of tea tree oil against azole-susceptible and -resistant human pathogenic yeasts. Journal of Antimicrobial Chemotherapy. 2003; 51, 1223–1229
