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Fungal Nail Test

ByPodiatry Station

Fungal Nail Test

Fungal Nail Test: How to diagnose a fungal nail infection

What is the first step in treating a Fungal Nail?

The most important stage is to correctly diagnose a fungal nail infection. Studies have shown that even experts (Dermatologists & Podiatrists) at very best can only be around 67% accurate by visual diagnosis, meaning they still get 1 in 3 diagnoses wrong. Clinical guidelines and published papers repeatedly state it is good practice to establish a formal diagnosis before treating. Why? This is because around half of thick discoloured nails are not fungal and you should not treat a patient for something they do not have!

How does the Dermatophyte Test Strip work?

This is also known as the 5-minute fungal nail test. The Dermatophyte Test Strip (DTS) works by a process known as immune-chromotography, similar to that used in a pregnancy test. The DTS contains a monoclonal antibody (MAB) that specifically reacts with a polysaccharide that is present in the cell wall of dermatophytes. When an infected nail sample is added to the buffer solution, the polysaccharide is released and picked up by the DTS. The fungal polysaccharide, if present, is absorbed into the test strip and then interacts with the MAB present in the strip.

How accurate is the test?

The DTS in published studies has been shown to have an accuracy of 97% – meaning you can be confident that the test will give results.

What species can the strip detect?

The test strip can rapidly detect the presence of different types of dermatophytes (T. rubrum, T. mentagrophytes [var. interdigitale], T. violaceum, T. tonsurans, Microsporum gypseum, M. canis and E. floccosum), including all the most commonly encountered species causing nail infection in the UK.

Is there reliable scientific evidence that the test really works?

Yes, the DTS has undergone rigorous testing and to-date a number of peer reviewed publications documenting its successful use have appeared in the British Journal of Dermatology and the Journal of Dermatology.

Can the test be used if the patient has been using anti-fungal treatments?

Yes, unlike traditional mycology, the test is unaffected by any anti-fungal treatments which may be present in a nail sample.
Therefore, do not delay seeking advice regarding your discoloured nails, as the sooner you have an accurate diagnosis, the better the outcome will be of your treatment!

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