Abstract
Objective: Several tests are currently used for diagnosis of onychomycosis and many health insurers are requiring the documentation of a positive laboratory test prior to approving payment of treatment for onychomycosis. The purpose of this study was to determine which of the following seven tests is the most sensitive for confirming the diagnosis of toenail onychomycosis: 20% potassium hydroxide (KOH) preparation (interpreted separately by a dermatologist and a mycologist); KOH enhanced preparation with Chlorazol Black E; KOH preparation with dimethylsulfoxide (DMSO); culture on Dermatophyte Test Medium (DTM); culture on Mycosel; and histological examination with Periodic-acid Schiff staining (PAS).
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