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Criteria of Scher et al for the Diagnosis of Onychomycosis Due to a Dermatophyte

Description

Scher et al outlined criteria for the diagnosis of onychomycosis causd by a dermatophyte. It is essential to establish the diagnosis prior to starting therapy since (1) nail changes may be nonspecific and (2) cure requires selection of an appropriate antifungal agent. The authors are from multiple hospitals in the United States and Europe.


 

The diagnosis of a dermatophyte-related onychomyosis requires the presence of both clinical and laboratory findings.

 

Key clinical findings

(1) white, yellow, orange or brown patches or streaks in the nails (often associated with dermatophytoma)

(2) presence of tinea pedis with toenail changes or tinea manuum with fingernail changes

 

Additional clinical findings that can be seen in both dermatophyte infections and other conditions:

(1) onycholysis

(2) subungual hyperkeratosis and debris

(3) thickening of the nail plate

 

Laboratory findings may include:

(1) positive microscopic examination performed on a nail specimen

(2) positive fungal culture

(3) PCR or other molecular technique

 


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