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논문KCI 등재

에머리보드와 수술용 블레이드를 이용한 손발톱진균증의 진균 배양 검사 양성율에 대한 비교 연구

Comparison of Fungal Culture Positivity using Surgical Blade and Emery Board in Onychomycosis Patients

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초록

Background: Usually, we did the fungus culture by collecting nail samples using a surgical blade, but this procedure showed low positive culture rate. An emery board is a tool used to gently grind down and shape the edges of nails. Objective: The aim of this study is to compare positive culture rates of nail sampling techniques in diagnosis of onychomycosis using surgical blade and emery board. Methods: We collected and assessed data of 49 patients in total, with chief complaints of nail problem, and showed positive results in KOH smear. Fungus culture was performed twice in each patient, both by scraping nail with surgical blades and grinding nail piece with emery board. After 4 weeks from culture, we compared positive culture rates of two nail sampling techniques. Results: In 49 patients, 16 patients were male and the other 33 were female, with average age of 51.4 years. When classified by morphological type, there were 45 cases of distal lateral subungual onychomycosis (DLSO) and 4 cases of white superficial onychomycosis (WSO). Culture using emery board produced 18 positive results (36.7%) out of 49 patients, and that using surgical blade produced 9 positive results (18.4%); the difference were statistically significant. In other words, nail sampling using emery board rather than surgical blade resulted in higher positive culture rate. Conclusion: Therefore, emery board can be used as a useful device for diagnosis and identification of causative fungi in onychomycosis in clinical practice and a method to enhance positive rates of cultures.

Abstract

Background: Usually, we did the fungus culture by collecting nail samples using a surgical blade, but this procedure showed low positive culture rate. An emery board is a tool used to gently grind down and shape the edges of nails. Objective: The aim of this study is to compare positive culture rates of nail sampling techniques in diagnosis of onychomycosis using surgical blade and emery board. Methods: We collected and assessed data of 49 patients in total, with chief complaints of nail problem, and showed positive results in KOH smear. Fungus culture was performed twice in each patient, both by scraping nail with surgical blades and grinding nail piece with emery board. After 4 weeks from culture, we compared positive culture rates of two nail sampling techniques. Results: In 49 patients, 16 patients were male and the other 33 were female, with average age of 51.4 years. When classified by morphological type, there were 45 cases of distal lateral subungual onychomycosis (DLSO) and 4 cases of white superficial onychomycosis (WSO). Culture using emery board produced 18 positive results (36.7%) out of 49 patients, and that using surgical blade produced 9 positive results (18.4%); the difference were statistically significant. In other words, nail sampling using emery board rather than surgical blade resulted in higher positive culture rate. Conclusion: Therefore, emery board can be used as a useful device for diagnosis and identification of causative fungi in onychomycosis in clinical practice and a method to enhance positive rates of cultures.

참고문헌 (13)

  1. Cho BK, "Infectious diseases of the nail", pp.103~122 (2009), Seoheung Publishing Co
  2. 신영민, "조갑진균증의 진단에 있어 KOH 검사, 진균 배양 검사, 병리 조직 검사 및중합효소 연쇄반응의 비교", 대한의진균학회지, 12(2), pp.59~69 (2007), 대한의진균학회
  3. Daniel CR, "The diagnosis of nail fungal infection", Arch Dermatol, 127, pp.1566~1567 (1991)
  4. Kim JW, "A clinical and mycological study of superficial fungal diseases", Korean J Dermatol, 11, pp.139~150 (1973)
  5. Rhim KJ, "A clinical and mycological study of superficial dermatophytoses", Korean J Dermatol, 16, pp.435~442 (1978)
  6. Weinberg JM, "Comparison of diagnostic methods in the evaluation of onychomycosis", J Am Acad Dermatol, 49, pp.193~197 (2003)
  7. Cho BK, "Korean Taskforce on onychomycosis education (K-TOE)", pp.33~38 (2006), Seoheung Publishing Co
  8. Paugam A, "Comparison of real-time PCR with conventional methods to detect dermatophytes in samples from patients with suspected dermatophytosis", J Microbiol Methods, 95, pp.218~222 (2013)
  9. Jung MY, "Comparison of diagnostic methods for onychomycosis, and proposal of a diagnostic algorithm", Clin Exp Dermatol, 40, pp.479~484 (2015)
  10. 문현주, "피부진균증의 임상 및 균학적 관찰 (1991-2000)", 대한의진균학회지, 7(2), pp.78~85 (2002), 대한의진균학회
  11. Suarez SM, "Histologic evaluation of nail clippings for diagnosing onychomycosis", Arch Dermatol, 127, pp.1517~1519 (1991)
  12. Zaias N, "Fungi in toe-nails", J Invest Dermatol, 55, pp.140~142 (1969)
  13. English MP, "An improved method for the isolation of fungi in onychomycosis", Br J Dermatol, 88, pp.237~241 (1973)

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