Diagnosis of toenail fungus is an important part in the handling of the infectious disease on nail. Toenail fungus (Onychomycosis) is a disease that takes a comprehensive treatment. To cure this infection, we need a long time and considerable cost. Therefore, the diagnosis of toenail fungus should be enforced properly. However, we must also consider cost in choosing a technique to diagnose toenail fungus.

During this time, there are seven techniques which are often used to diagnose toenail fungus: potassium hydroxide preparation interpreted by a dermatologist (KOH-CLINIC), potassium hydroxide preparation interpreted by a laboratory technician (KOH-LAB), KOH with dimethyl sulfoxide (KOH-DMSO) interpreted by a dermatologist, KOH with chlorazol black E (KOH-CBE) interpreted by a dermatologist, culture using dermatophyte test medium, culture with Mycobiotic and Inhibitory Mold Agar, and PATHPAS method. Some researchers from the University of Minnesota compare these methods to find the most cost effective technique in diagnosing toenail fungus.

Study involving two hundred four participants proved that the sensitivity of KOH-CBE method is similar to PATHPAS. In this study, PATHPAS is indeed the most sensitive diagnostic technique (98.8%). PATHPAS has much higher sensitivity than other diagnostic tests except for KOH-CBE. Diagnosis using KOH with black chlorazol E Interpreted by a dermatologist has a high sensitivity of 94.3%. The sensitivity is lower compared with PATHPAS. However, the differences were not statistically significant. PATHPAS is a method that is quite expensive. In this research, the most cost effective diagnostic techniques for toenail fungus is KOH-CBE. Unfortunately, this study did not evaluate specificity in comparing several techniques of diagnosis. Practitioners can choose the KOH-CBE to diagnose toenail fungus because this technique has high sensitivity and most cost-effective.

Reference:

Lilly K.K., Koshnick R.L., Grill J.P., Khalil Z.M., Nelson D.B., Warshaw E.M. Cost-effectiveness of diagnostic tests for toenail onychomycosis: A repeated-measure, single-blinded, cross-sectional evaluation of 7 diagnostic tests (2006) Journal of the American Academy of Dermatology, 55 (4), pp. 620-626.

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Cat : toenail fungus infection, tags: black toenail diagnosis, clinical examination, dermatology koh, Onychomycosis, pathpas, toenail fungus diagnosis technique pathpas, what is most effective for toenail fungus