Fungal Nail Infection Evaluation
The evaluation of a fungal nail infection starts with a medical history and physical exam.
The diagnosis of a fungal nail infection can be made on physical exam.
Physical findings in someone with a fungal nail infection may include:
- Coarse thickening and elevation of nails
- Distortion and dullness of the nails
- Splitting and flaking of nails
- Yellow-brown discoloration
Tests may be used to confirm the diagnosis of fungal nail infection.
Tests that may be used to evaluate fungal nail infection include:
- KOH preparation procedure:
- Clip or file away some of nail plate, and collect scales from beneath the nail onto a glass slide with coverslip
- Apply 10-20% potassium hydroxide solution and heat gently without boiling
- Let stand for 5 minutes and examine under a microscope for septate, branching hyphae.
Continue to Fungal Nail Infection Treatment
- Gupta AK, Lynch LE. Onychomycosis: review of recurrence rates, poor prognostic factors, and strategies to prevent disease recurrence. Cutis. 2004 Jul;74(1 Suppl):10-5. 
- Gupta AK, Ryder J, Summerbell RC. Comparison of efficacy criteria across onychomycosis trials: need for standardization. Int J Dermatol. 2003 Apr;42(4):312-5. 
- Jain S, Sehgal VN. Itraconazole versus terbinafine in the management of onychomycosis: an overview. J Dermatolog Treat. 2003 Jan;14(1):30-42. 
- Krob AH, Fleischer AB Jr, D'Agostino R Jr, Feldman SR. Terbinafine is more effective than itraconazole in treating toenail onychomycosis: results from a meta-analysis of randomized controlled trials. J Cutan Med Surg. 2003 Jul-Aug;7(4):306-11.