Stephen J. Schueler, M.D.

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Nail Fungus 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 Nail Fungus Treatment

Last Updated: Dec 13, 2010 References
Authors: Stephen J. Schueler, MD; John H. Beckett, MD; D. Scott Gettings, MD
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PubMed Nail Fungus References
  1. 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. [15287395]
  2. 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. [12694503]
  3. Jain S, Sehgal VN. Itraconazole versus terbinafine in the management of onychomycosis: an overview. J Dermatolog Treat. 2003 Jan;14(1):30-42. [12745853]
  4. 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. [14738099]
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