{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T21:51:17Z","timestamp":1790718677646,"version":"4.1.0"},"reference-count":29,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2024,9,17]],"date-time":"2024-09-17T00:00:00Z","timestamp":1726531200000},"content-version":"vor","delay-in-days":16,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Mycoses"],"published-print":{"date-parts":[[2024,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Several clinical signs in dermatoscopy are very characteristic of onychomycosis and can be a quick complement for the diagnosis of onychomycosis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objectives<\/jats:title><jats:p>The aim of this study was to evaluate the diagnostic accuracy of dermatoscopy compared to microbiological culture and polymerase chain reaction (PCR), as well as the clinical signs associated with onychomycosis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The clinical signs of 125 patients were assessed cross\u2010sectionally using dermatoscopy, and a positive or negative result was assigned. A sample was then taken for PCR and microbiological culture.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of the 125 patients, 69.6% (87\/125) had positive results when both laboratory tests were combined. When they were not combined, the prevalence was lower at 48% (60\/125) with PCR and at 43.2% (54\/125) with culture. Furthermore, 76.8% (96\/125) were classified as positive with dermatoscopy with a sensitivity of 1, a specificity of 0.76, positive predictive value of 0.91 and negative predictive value of 1 (with 95% confidence intervals). Of the 96 dermatoscopy\u2010positive samples, 36 were negative with PCR (<jats:italic>p\u2009&lt;<\/jats:italic>\u20090.001), 42 were negative with culture (<jats:italic>p\u2009&lt;<\/jats:italic>\u20090.001) and nine were negative when both tests were combined (<jats:italic>p\u2009&lt;<\/jats:italic>\u20090.001). Clinical signs that were significantly associated with the presence of onychomycosis were subungual hyperkeratosis (dermatoscopy: <jats:italic>p\u2009=<\/jats:italic>\u20090.004, odds ratio (OR)\u2009=\u20092.438; PCR\u2009+\u2009microbiological culture: <jats:italic>p\u2009=<\/jats:italic>\u20090.004, OR\u2009=\u20093.221), subungual detritus (<jats:italic>p\u2009=<\/jats:italic>\u20090.033, OR\u2009=\u20093.01, only with dermatoscopy) and dermatophytoma (dermatoscopy: <jats:italic>p\u2009=<\/jats:italic>\u20090.049, OR\u2009=\u20093.02; PCR\u2009+\u2009microbiological culture: <jats:italic>p\u2009=<\/jats:italic>\u20090.022, OR\u2009=\u20092.40).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The results suggest that dermatoscopy is a good tool for the diagnosis of onychomycosis but should be used as a complementary test or for screening patients to be sampled for laboratory testing. The combination of the three tests can lead to a reduction of false\u2010positive and false\u2010negative clinical and laboratory results. This allows for early diagnosis and specific treatment based on test results.<\/jats:p><\/jats:sec>","DOI":"10.1111\/myc.13799","type":"journal-article","created":{"date-parts":[[2024,9,18]],"date-time":"2024-09-18T04:13:30Z","timestamp":1726632810000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Diagnostic Accuracy of Dermatoscopy Versus Microbiological Culture and Polymerase Chain Reaction in the Diagnosis of Onychomycosis: A Cross\u2010Sectional Study"],"prefix":"10.1111","volume":"67","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3588-0557","authenticated-orcid":false,"given":"David","family":"Navarro\u2010P\u00e9rez","sequence":"first","affiliation":[{"name":"Diabetic Foot Unit, Cl\u00ednica Universitaria de Podolog\u00eda, Facultad de Enfermer\u00eda, Fisioterapia y Podolog\u00eda Universidad Complutense de Madrid. Instituto de Investigaci\u00f3n Sanitaria del Hospital Cl\u00ednico San Carlos (IdISSC)  Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5650-7351","authenticated-orcid":false,"given":"Aroa","family":"Tard\u00e1guila\u2010Garc\u00eda","sequence":"additional","affiliation":[{"name":"Diabetic Foot Unit, Cl\u00ednica Universitaria de Podolog\u00eda, Facultad de Enfermer\u00eda, Fisioterapia y Podolog\u00eda Universidad Complutense de Madrid. Instituto de Investigaci\u00f3n Sanitaria del Hospital Cl\u00ednico San Carlos (IdISSC)  Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2937-7122","authenticated-orcid":false,"given":"Sara","family":"Garc\u00eda\u2010Oreja","sequence":"additional","affiliation":[{"name":"Cl\u00ednica Universitaria de Podolog\u00eda, Facultad de Enfermer\u00eda, Fisioterapia y Podolog\u00eda Universidad Complutense de Madrid. Instituto de Investigaci\u00f3n Sanitaria del Hospital Cl\u00ednico San Carlos (IdISSC)  Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-7973-9652","authenticated-orcid":false,"given":"Diego","family":"Le\u00f3n\u2010Herce","sequence":"additional","affiliation":[{"name":"Cl\u00ednica Universitaria de Podolog\u00eda, Facultad de Enfermer\u00eda, Fisioterapia y Podolog\u00eda Universidad Complutense de Madrid. Instituto de Investigaci\u00f3n Sanitaria del Hospital Cl\u00ednico San Carlos (IdISSC)  Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4674-3822","authenticated-orcid":false,"given":"Francisco\u00a0Javier","family":"\u00c1lvaro\u2010Afonso","sequence":"additional","affiliation":[{"name":"Diabetic Foot Unit, Cl\u00ednica Universitaria de Podolog\u00eda, Facultad de Enfermer\u00eda, Fisioterapia y Podolog\u00eda Universidad Complutense de Madrid. Instituto de Investigaci\u00f3n Sanitaria del Hospital Cl\u00ednico San Carlos (IdISSC)  Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6110-0265","authenticated-orcid":false,"given":"Jos\u00e9\u00a0Luis","family":"L\u00e1zaro\u2010Mart\u00ednez","sequence":"additional","affiliation":[{"name":"Diabetic Foot Unit, Cl\u00ednica Universitaria de Podolog\u00eda, Facultad de Enfermer\u00eda, Fisioterapia y Podolog\u00eda Universidad Complutense de Madrid. Instituto de Investigaci\u00f3n Sanitaria del Hospital Cl\u00ednico San Carlos (IdISSC)  Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,9,17]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1177\/1203475417716362"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1159\/000485632"},{"issue":"1","key":"e_1_2_10_4_1","first-page":"CD012093","article-title":"Topical and Device\u2010Based Treatments for Fungal Infections of the Toenails","volume":"16","author":"Foley K.","year":"2020","journal-title":"Cochrane Database of Systematic Reviews"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/myc.13577"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/myc.13725"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/jdv.16394"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/myc.13648"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/myc.13683"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2230.2011.04082.x"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1468-3083.2011.04323.x"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.3399\/BJGPO.2022.0186"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.5021\/ad.22.130"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.3390\/jof8020135"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.4103\/ijdvl.IJDVL_100_19"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.3389\/fmed.2022.1048913"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00403-017-1796-2"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.5826\/dpc.0502a05"},{"issue":"1","key":"e_1_2_10_19_1","first-page":"11","article-title":"Onychoscopy: A Quick and Effective Tool for Diagnosing Onychomycosis in a Resource\u2010Poor Setting","volume":"30","author":"Hazarika N.","year":"2021","journal-title":"Acta Dermatovenerologica Alpina, Panonica et Adriatica"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2013.281053"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1099\/jmm.0.46723-0"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.7547\/15\u2010136"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.1111\/jdv.19217"},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.3390\/jof9070710"},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.1111\/jdv.17241"},{"key":"e_1_2_10_26_1","doi-asserted-by":"publisher","DOI":"10.1002\/hsr2.1694"},{"issue":"11","key":"e_1_2_10_27_1","first-page":"762","article-title":"Onychomycosis: Current Trends in Diagnosis and Treatment","volume":"88","author":"Westerberg D. P.","year":"2013","journal-title":"American Family Physician"},{"key":"e_1_2_10_28_1","doi-asserted-by":"publisher","DOI":"10.1111\/myc.13721"},{"key":"e_1_2_10_29_1","doi-asserted-by":"publisher","DOI":"10.1111\/myc.13694"},{"key":"e_1_2_10_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2018.03.062"}],"container-title":["Mycoses"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/myc.13799","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,9,27]],"date-time":"2024-09-27T05:51:08Z","timestamp":1727416268000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/myc.13799"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,9]]},"references-count":29,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2024,9]]}},"alternative-id":["10.1111\/myc.13799"],"URL":"https:\/\/doi.org\/10.1111\/myc.13799","archive":["Portico"],"relation":{},"ISSN":["0933-7407","1439-0507"],"issn-type":[{"value":"0933-7407","type":"print"},{"value":"1439-0507","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,9]]},"assertion":[{"value":"2024-06-10","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-09-06","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-09-17","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e13799"}}