Onychomycosis: Usefulness of Histomycology

Abstract

Onychomycosis is a highly prevalent disease worldwide. Accurate diagnosis is therefore required for the ongoing treatment and management of onychomycosis and to avoid misdiagnosis and treatment delay, which can be both lengthy and costly. There is no standard test for its diagnosis. Histomycology is rapid and easy to achieve. It increases the sensitivity in diagnosing onychomycosis above that achieved by standard examinations (culture and KOH direct exam). The location of the fungus also can be determined with precision. Invading fungi thus can be distinguished from colonizing or contaminating agents. Information concerning the viability of the fungi and accurate identification of the specific pathogen are not available through PAS histology alone. In addition, histomycology can also be used as a simple test to evaluate the effectiveness of the prescribed mycological treatment. It is the most sensitive method for detecting residual infection after therapy with oral antifungal medication. A combination of histomycology and culture is recommended to obtain an accurate diagnosis of onychomycosis.