{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T11:13:10Z","timestamp":1783509190994,"version":"3.55.0"},"reference-count":6,"publisher":"MDPI AG","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2015,11]]},"abstract":"<jats:title\/>\n                  <jats:sec id=\"st1\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Onychomycosis is a fungal infection of the nail that can be caused by dermatophytes, yeasts, or nondermatophyte molds. To diagnose onychomycosis, a clinician must use the patient's history, physical findings, and diagnostic testing, which can include calcofluor white\/potassium hydroxide (KOH) mount, fungal culture (FC), and periodic acid\u2013Schiff (PAS) stain. Some insurance companies require authorization for antifungal medication and request laboratory results to confirm infection. We sought to compare the reliability of KOH, PAS, and FC diagnostic results for confirmation of fungal disease, to determine the sensitivity and specificity of each test, and to investigate the cost of each test. In addition, we statistically observed the relationship between the test results and demographic variables.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"st2\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Toenail clippings were obtained from 108 patients clinically diagnosed as having onychomycosis. Diagnostic tests were then performed on each sample; the results were obtained from medical records.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"st3\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>For PAS, KOH, and FC, 60.2%, 43.5%, and 39.8% of results, respectively, were positive. Agreement for each pair of tests was slightly higher for FC and KOH. Sensitivities for KOH and PAS were 0.64 and 0.79, respectively. Specificity was 0.79 for KOH and 0.54 for PAS. Both PAS and KOH had a higher percentage of positive test results for men than for women.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"st4\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Of the three tests evaluated, PAS gives the most consistent positive results and has the highest sensitivity. Therefore, PAS should be considered as the best test to verify clinically significant onychomycosis.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.7547\/14-063.1","type":"journal-article","created":{"date-parts":[[2015,12,14]],"date-time":"2015-12-14T18:38:10Z","timestamp":1450118290000},"page":"503-508","source":"Crossref","is-referenced-by-count":18,"title":["A Retrospective Review of Diagnostic Testing for Onychomycosis of the Foot"],"prefix":"10.3390","volume":"105","author":[{"given":"Nell","family":"Blake","sequence":"first","affiliation":[{"name":"Department of Orthopaedics and Rehabilitation, Penn State Hershey Bone and Joint Institute, Hershey, PA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Junjia","family":"Zhu","sequence":"additional","affiliation":[{"name":"Department of Public Health Sciences, Penn State Hershey College of Medicine, Hershey, PA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giselle","family":"Hernandez","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics and Rehabilitation, Penn State Hershey Bone and Joint Institute, Hershey, PA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul Joseph","family":"Juliano","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics and Rehabilitation, Penn State Hershey Bone and Joint Institute, Hershey, PA."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","reference":[{"key":"i8750-7315-105-6-503-b01","series-title":"Indian J Med Microbiol","doi-asserted-by":"publisher","first-page":"108","DOI":"10.1016\/S0255-0857(21)01924-1","article-title":"Onychomycosis: epidemiology, diagnosis and management","volume":"26","author":"Kaur\n              R,","year":"2008","unstructured":"Kaur\n              R, \n            \n              Kashyap\n              B, \n            \n              Bhalla\n              P: \n          \n          Onychomycosis: epidemiology, diagnosis and management. Indian J Med Microbiol26: 108, 2008.1844594410.1016\/S0255-0857(21)01924-1"},{"key":"i8750-7315-105-6-503-b02","series-title":"J Am Acad Dermatol","doi-asserted-by":"publisher","first-page":"620","DOI":"10.1016\/j.jaad.2006.03.033","article-title":"Cost-effectiveness of diagnostic tests for toenail onychomycosis: a repeated-measure, single-blinded, cross-sectional evaluation of 7 diagnostic tests","volume":"55","author":"Lilly\n              KK,","year":"2006","unstructured":"Lilly\n              KK, \n            \n              Koshnick\n              RL, \n            \n              Grill\n              JP, \n            et al\n          : Cost-effectiveness of diagnostic tests for toenail onychomycosis: a repeated-measure, single-blinded, cross-sectional evaluation of 7 diagnostic tests. J Am Acad Dermatol55: 620, 2006.10.1016\/j.jaad.2006.03.03317010741"},{"key":"i8750-7315-105-6-503-b03","series-title":"Br J Dermatol","doi-asserted-by":"publisher","first-page":"743","DOI":"10.1111\/j.1365-2133.2010.09930.x","article-title":"Clinical diagnosis of toenail onychomycosis is possible in some patients: cross-sectional diagnostic study and development of a diagnostic rule","volume":"163","author":"Garcia-Doval\n              I,","year":"2010","unstructured":"Garcia-Doval\n              I, \n            \n              Cabo\n              F, \n            \n              Monteagudo\n              B, \n            et al\n          : Clinical diagnosis of toenail onychomycosis is possible in some patients: cross-sectional diagnostic study and development of a diagnostic rule. Br J Dermatol163: 743, 2010.http:\/\/gateway.webofknowledge.com\/gateway\/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000282046600013&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=b7bc2757938ac7a7a821505f8243d9f310.1111\/j.1365-2133.2010.09930.x20618320"},{"key":"i8750-7315-105-6-503-b04","series-title":"Br J Dermatol","doi-asserted-by":"publisher","first-page":"749","DOI":"10.1046\/j.1365-2133.2003.05029.x","article-title":"Histopathological diagnosis of onychomycosis by periodic acid-Schiff-stained nail clippings","volume":"148","author":"Reisberger\n              EM,","year":"2003","unstructured":"Reisberger\n              EM, \n            \n              Abels\n              C, \n            \n              Landthaler\n              M, \n            et al\n          : Histopathological diagnosis of onychomycosis by periodic acid-Schiff-stained nail clippings. Br J Dermatol148: 749, 2003.10.1046\/j.1365-2133.2003.05029.x12752134"},{"key":"i8750-7315-105-6-503-b05","series-title":"J Am Acad Dermatol","doi-asserted-by":"publisher","first-page":"193","DOI":"10.1067\/S0190-9622(03)01480-4","article-title":"Comparison of diagnostic methods in the evaluation of onychomycosis","volume":"49","author":"Weinberg\n              JM,","year":"2003","unstructured":"Weinberg\n              JM, \n            \n              Koestenblatt\n              EK, \n            \n              Tutrone\n              WD, \n            et al\n          : Comparison of diagnostic methods in the evaluation of onychomycosis. J Am Acad Dermatol49: 193, 2003.10.1067\/S0190-9622(03)01480-412894064"},{"key":"i8750-7315-105-6-503-b06","series-title":"Arch Dermatol","doi-asserted-by":"publisher","first-page":"1112","DOI":"10.1001\/archderm.136.9.1112","article-title":"Methods for diagnosing onychomycosis: a comparative study and review of the literature","volume":"136","author":"Lawry\n              MA,","year":"2000","unstructured":"Lawry\n              MA, \n            \n              Haneke\n              E, \n            \n              Strobeck\n              K, \n            et al\n          : Methods for diagnosing onychomycosis: a comparative study and review of the literature. Arch Dermatol136: 1112, 2000.10.1001\/archderm.136.9.111210987866"}],"container-title":["Journal of the American Podiatric Medical Association"],"original-title":[],"link":[{"URL":"https:\/\/japmaonline.org\/view\/journals\/apms\/105\/6\/14-063.1.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/meridian.allenpress.com\/japma\/article-pdf\/105\/6\/503\/1605224\/14-063_1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/japmaonline.org\/downloadpdf\/journals\/apms\/105\/6\/14-063.1.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/japmaonline.org\/downloadpdf\/journals\/apms\/105\/6\/14-063.1.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T10:13:06Z","timestamp":1783505586000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1930-8264\/105\/6\/503"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2015,11]]},"references-count":6,"journal-issue":{"issue":"6"},"URL":"https:\/\/doi.org\/10.7547\/14-063.1","relation":{},"ISSN":["8750-7315","1930-8264"],"issn-type":[{"value":"8750-7315","type":"print"},{"value":"1930-8264","type":"electronic"}],"subject":[],"published":{"date-parts":[[2015,11]]}}}