Como o clipping pode auxiliar o dermatologista

Neto, José Fillus; Tchornobay, Ana Maria

doi:10.1590/s0365-05962009000200010

Cited by 15 publications

(9 citation statements)

References 6 publications

(2 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Onychomycosis is the most prevalent nail disease, amounting to about 50% of all onychopathies . The diagnosis is still a challenge considering that the gold standard complementary test (direct microscopy and culture) may be false‐negative in up to 35% of the cases …”

Section: Dermoscopy Characteristics and Complementary Examsmentioning

confidence: 99%

Dermatoscopy of onychomycosis

Crignis¹,

Valgas²,

Rezende³

et al. 2013

Int J Dermatology

View full text Add to dashboard Cite

Section: Dermoscopy Characteristics and Complementary Examsmentioning

confidence: 99%

Dermatoscopy of onychomycosis

Crignis¹,

Valgas²,

Rezende³

et al. 2013

Int J Dermatology

View full text Add to dashboard Cite

“…2,12 However, although treatments for onychomycosis imply a high cost, collateral effects, and prolonged treatment time, in practice they are not used only when there is confirmed diagnosis, and negligent patients usually do not see the doctor to receive appropriate guidance and treatments; in addition, empirical treatments are prescribed when there is only clinical suspicion but no laboratory confirmation of onychomycosis. 13 …”

Section: Introductionmentioning

confidence: 99%

Onychomycosis: clinical, mycological and in vitro susceptibility testing of isolates of Trichophyton rubrum

Azambuja

Pimmel

Klafke

et al. 2014

An. Bras. Dermatol.

View full text Add to dashboard Cite

BACKGROUND Onychomycosis or nail fungal infection is the most common nail disease. Despite the wide range of studies on this condition, it remains difficult to establish the correct diagnosis and effective treatment. OBJECTIVES To evaluate the efficacy of classical laboratory methods for the diagnosis of onychomycosis, and the in vitro susceptibility of the its main etiological agent to antifungals used in routine. METHODS Nail samples of 100 patients with clinically suspected feet onychomycosis were collected to confirm the diagnosis by direct mycological examination and fungal culture. In vitro antifungal susceptibility testing was performed against strains of the main dermatophyte isolated by microdilution, according to the standardized protocol (M38-A2 - CLSI) RESULTS Clinical diagnosis of onychomycosis was confirmed by laboratory analysis in 59% of patients. Of these, 54.2% were positive only in direct mycological examination, 44.1% in direct mycological examination and culture, and one case (1.7%) was positive only in culture, resulting in weak agreement between these tests (Kappa = 0.385; p <0.001) High minimum inhibitory concentration values of fluconazole and itraconazole were observed in 66.7% and 25.0% of isolates of T. rubrum tested. Additionally, high MIC values of terbinafine and ciclopirox was detected in only one isolate, and this was one of the strains in which in vitro activity of itraconazole and fluconazole has not been proven. CONCLUSIONS Poor agreement was observed between direct mycological examination and culture for the diagnosis of onychomycosis, with direct mycological examination being significantly more sensitive. Except for fluconazole, the other three antifungals tested showed good in vitro activity against clinical isolates of T. rubrum.

show abstract

“…The techniques described in the literature for nail processing vary, though. The majority of nail clipping studies fix the specimens in formalin [1–8, 10,17], some apply substances for softening of the nail plate, like chitin-softening solution [1,10] and Tween solution [5]. Several articles mentioned using traditional routine histologic examination for nail processing [1,2,3,7,10], few studies applied what seemed to be a diverse microscopic processing only with a series of ethanol [4,6], and a few did not use any microscopic processing at all after fixing with formalin and before paraffin embedding [5,8].…”

Section: Discussionmentioning

confidence: 99%

“…Several articles mentioned using traditional routine histologic examination for nail processing [1,2,3,7,10], few studies applied what seemed to be a diverse microscopic processing only with a series of ethanol [4,6], and a few did not use any microscopic processing at all after fixing with formalin and before paraffin embedding [5,8]. One study obtained good histologic preparations without using a fixative and immersed nail fragments in a solution of liquid hand soap and distilled water followed by a process in a routine overnight cycle [16], and in only two reports the samples examined were immediately wrapped in paraffin without using a fixative liquid [9,17]. …”

Section: Discussionmentioning

confidence: 99%

Microscopic examination of normal nail clippings

Werner

Antunes

2013

Dermatol Pract Concept

View full text Add to dashboard Cite

Background:Nail clipping analysis for diagnosing causes of onychodystrophy other than onychomycosis is investigated to a very small extent. In order to achieve acceptance as a diagnostic method for any kind of nail abnormalities, normal microscopic parameters have to be established first. In most reported cases, nail plates were fixed in formalin with processing of the specimens with routine automated histotechnique.Methodology:Fifteen pairs of normal nails were studied. One nail fragment was placed in a container with formalin, and the other was kept dry in a proper receptacle. Fixed specimens were submitted to standard automated tissue processing (formalin group) and dry specimens were directly embedded in paraffin (dry group). Several microscopic parameters were analyzed.Results:Nail plate thickness ranged from 0.25 to 0.50 mm (mean 0.36 mm) and subungual region from 0 to 0.31 mm (mean 0.11 mm). Forty-one percent of cases presented onychokaryosis, and hypereosinophilic nuclear shadows were detected in 63%, statistically more frequent in the dry group (p=0.002). Parakeratosis was present in 86% of nails varying from 1 to 13 layers (mean 5.6). None of the nails presented fungi, neutrophils, and blood or serum collections. Bacteria were seen in 60% of specimens. Both groups yielded adequate microscopic preparations for analysis with no statistical difference in the dryness or hardness of specimens or difficulty in cutting the paraffin blocks (p=1).Conclusion:These microscopic findings of a normal population can be used as parameters for evaluating any cause of onychodystrophy. The dry method is faster and cheaper and yields adequate slide preparations for microscopic analysis of nail clippings.

show abstract

Como o clipping pode auxiliar o dermatologista

Cited by 15 publications

References 6 publications

Dermatoscopy of onychomycosis

Dermatoscopy of onychomycosis

Onychomycosis: clinical, mycological and in vitro susceptibility testing of isolates of Trichophyton rubrum

Microscopic examination of normal nail clippings

Contact Info

Product

Resources

About