Analysis of treatment results and treatment compliance according to diagnostic tests in onychomycosis = Analysis of treatment results and treatment compliance according to diagnostic tests in onychomycosis

다국어 초록 (Multilingual Abstract)

Background: Onychomycosis is a fungal infection of toenails and fingernails. It is diagnosed with suggestive clinical findings, but direct microscopy with KOH, fungus culture or nail histopathology are useful methods to confirm definite diagnosis. Misdiagnosis of onychomycosis can cause unnecessary long term antifungal medication, with unexpected costs and side effects such as liver toxicity.
Objectives: The aim of our study is to analyze treatment results and compliance of onychomycosis patients according to diagnostic tests in order to suggest appropriate test methods for the patients.
Methods: We evaluated patients referred from primary physician from January 2016 to March 2018. The patients diagnosed as onychomycosis were classified into four groups according to the test methods- A, KOH test only, B, nail histopathology only, C, both KOH and histopathology, and D, nail histopathology and fungus culture. We compared each group in treatment results and compliance.
Results: Comparing group B with group C and D, the patients who had more than two confirmation tests, chi square test showed statistically significant correlation with treatment outcome(p=0.017).
Conclusion: This study revealed that the patient confirmed by more than two diagnostic tests had better treatment outcome than the one with single nail histopathology test. Herein, we suggest necessity of additional confirmation tests such as histopathology or fungus culture in untreatable patients referred from primary physicians.