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Toenail Fungus Test Is Both Accurate and Affordable

Potassium hydroxide preparation with chlorazol black E is most cost-effective of seven tests

THURSDAY, Oct. 12 (HealthDay News) -- The best diagnostic test for toenail onychomycosis is potassium hydroxide preparation with chlorazol black E (KOH-CBE) due to a combination of test sensitivity and cost-effectiveness, researchers report in the October issue of the Journal of the American Academy of Dermatology.

Kia Lilly, M.D., of the University of Minnesota in Minneapolis, and colleagues compared the affordability of seven tests ordinarily used to diagnose toenail onychomycosis in 204 participants aged an average of 69.5 years, of whom 95.5 percent were men.

The researchers found that histopathologic analysis with periodic acid-Schiff stain was the most expensive but the most reliable test at 98.8 percent sensitivity, while KOH-CBE had 94.3 percent sensitivity.

The least reliable test was dermatophyte test medium at 57.3 percent, the report indicates. Except for potassium hydroxide preparation analyzed by a laboratory technician and potassium hydroxide preparation analyzed by a dermatologist, KOH-CBE was the most affordable test.

"KOH-CBE should be the test of choice for practitioners confident in interpreting potassium hydroxide preparations because of its combination of high sensitivity and cost-effectiveness," the authors conclude.

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