{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,11]],"date-time":"2026-11-11T03:40:35Z","timestamp":1794368435652,"version":"4.9.0"},"reference-count":27,"publisher":"Pensoft Publishers","issue":"6","license":[{"start":{"date-parts":[[2022,12,31]],"date-time":"2022-12-31T00:00:00Z","timestamp":1672444800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["FM"],"abstract":"<jats:p><jats:bold>Introduction<\/jats:bold>: Onychomycosis is a frequent nail disorder, accounting for up to 50% of all nail problems. Treatment of onychomycosis is expensive and requires a long time of antifungal medications. Consequently, a proper and faster diagnosis is necessary. Especially for those patients with diabetes mellitus, where onychomycosis is among the most significant predictors of foot ulcer and possible severe complications.<\/jats:p>\n          <jats:p><jats:bold>Aim<\/jats:bold>: To compare the sensitivity, specificity, and turnaround time between direct microscopy, culture, histology, and real-time PCR. In addition, to compare the frequency and etiology of onychomycosis in patients with and without DM.<\/jats:p>\n          <jats:p><jats:bold>Materials and methods<\/jats:bold>: This study included 102 patients, divided into two groups. One group consisted of patients with diabetes mellitus and the other \u2013 without diabetes. Nail samples were collected and examined by direct KOH microscopic examination, culture, histology, and real-time PCR.<\/jats:p>\n          <jats:p><jats:bold>Results<\/jats:bold>: From the 102 patients with clinical onychomycosis, positive KOH was found in 38 (37.3%). Culture \u2013 82 out of 102 samples (80.4%) were positive for dermatophytes, yeasts, and\/or NDM. Positive histology samples were 32 (41.6%). The PCR was positive in 57 (55.9%) out of the 102. We discovered that there is no significant statistical difference in the etiology of the fungal infections between the two groups.<\/jats:p>\n          <jats:p><jats:bold>Conclusions<\/jats:bold>: All mycological investigations have their place in the diagnosis of onychomycosis. Direct microscopy, culture, and histology are useful methods for clinicians to diagnose and follow up the post-treatment period. The advantages of RT-PCR include obtaining results faster and accurately identifying fungi, thus becoming more valued in the diagnosis of OM.<\/jats:p>","DOI":"10.3897\/folmed.64.e85486","type":"journal-article","created":{"date-parts":[[2022,12,31]],"date-time":"2022-12-31T10:02:45Z","timestamp":1672480965000},"page":"922-931","source":"Crossref","is-referenced-by-count":6,"title":["In search of dermatophytes \u2013 frequency and etiology of fungal infections in patients with and without diabetes mellitus"],"prefix":"10.3897","volume":"64","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2588-600X","authenticated-orcid":true,"given":"Gergana Z.","family":"Vazheva","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liliya G.","family":"Zisova","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elena A.","family":"Becheva","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Veselin R.","family":"Chonov","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valentin D.","family":"Dichev","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tsonka M.","family":"Miteva-Katrandzhieva","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zoya V.","family":"Rachkovska","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9918-0707","authenticated-orcid":true,"given":"Maria M.","family":"Orbetzova","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Veselin T.","family":"Belovezhdov","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2258","published-online":{"date-parts":[[2022,12,31]]},"reference":[{"key":"85486_B1","doi-asserted-by":"crossref","unstructured":"1. 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Comparison of potassium hydroxide mount and mycological culture with histopathologic examination using periodic acid-Schiff staining of the nail clippings in the diagnosis of onychomycosis. Indian J Dermatol Venereol Leprol 2008; 74(3):226\u20139.","DOI":"10.4103\/0378-6323.39584"},{"key":"85486_B23","doi-asserted-by":"crossref","unstructured":"23. Cuch\u00ed-Burgos E, Rubio-Casino R, Ballestero-T\u00e9llez M, et al. Commercial real time PCR implementation for rapid diagnosis of onychomycosis: a new workflow in a clinical laboratory. Enfermedades Infecc y Microbiol Clin (English ed). 2021; 39(7):326\u20139.","DOI":"10.1016\/j.eimce.2020.05.019"},{"key":"85486_B24","doi-asserted-by":"crossref","unstructured":"24. Kupsch C, Ohst T, Pankewitz F, et al. The agony of choice in dermatophyte diagnostics \u2013 performance of different molecular tests and culture in the detection of Trichophyton rubrum and Trichophyton interdigitale. 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