Ex vivo Confocal Laser Scanning Microscopy: A Potential New Diagnostic Imaging Tool in Onychomycosis Comparable With Gold Standard Techniques
Ex vivo confocal laser scanning microscopy (CLSM) is an innovative imaging tool that enables real-time examination of specimens and may be used in evaluating fungal infections. We aimed to assess the applicability of ex vivo CLSM in the diagnosis of onychomycosis by comparing results to those obtain...
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| Veröffentlicht in: | Frontiers in medicine Jg. 7; S. 586648 |
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| Abstract | Ex vivo confocal laser scanning microscopy (CLSM) is an innovative imaging tool that enables real-time examination of specimens and may be used in evaluating fungal infections. We aimed to assess the applicability of ex vivo CLSM in the diagnosis of onychomycosis by comparing results to those obtained by histopathology, potassium hydroxide (KOH) examination, and fungal culture. In this prospective study, 57 patients with the clinical diagnosis of distal nail fungal infection were examined and compared using all four of the above-mentioned diagnostic tools in terms of sensitivity, positive and negative predictive value. Ex vivo CLSM showed the highest sensitivity, followed by KOH examination, histopathology and fungal culture. Regarding positive and negative predictive values, ex vivo CLSM was superior and showed even higher sensitivity than the combined gold standard comprised of KOH examination, fungal culture or histopathology. |
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| AbstractList | Ex vivo confocal laser scanning microscopy (CLSM) is an innovative imaging tool that enables real-time examination of specimens and may be used in evaluating fungal infections. We aimed to assess the applicability of ex vivo CLSM in the diagnosis of onychomycosis by comparing results to those obtained by histopathology, potassium hydroxide (KOH) examination, and fungal culture. In this prospective study, 57 patients with the clinical diagnosis of distal nail fungal infection were examined and compared using all four of the above-mentioned diagnostic tools in terms of sensitivity, positive and negative predictive value. Ex vivo CLSM showed the highest sensitivity, followed by KOH examination, histopathology and fungal culture. Regarding positive and negative predictive values, ex vivo CLSM was superior and showed even higher sensitivity than the combined gold standard comprised of KOH examination, fungal culture or histopathology. Ex vivo confocal laser scanning microscopy (CLSM) is an innovative imaging tool that enables real-time examination of specimens and may be used in evaluating fungal infections. We aimed to assess the applicability of ex vivo CLSM in the diagnosis of onychomycosis by comparing results to those obtained by histopathology, potassium hydroxide (KOH) examination, and fungal culture. In this prospective study, 57 patients with the clinical diagnosis of distal nail fungal infection were examined and compared using all four of the above-mentioned diagnostic tools in terms of sensitivity, positive and negative predictive value. Ex vivo CLSM showed the highest sensitivity, followed by KOH examination, histopathology and fungal culture. Regarding positive and negative predictive values, ex vivo CLSM was superior and showed even higher sensitivity than the combined gold standard comprised of KOH examination, fungal culture or histopathology.Ex vivo confocal laser scanning microscopy (CLSM) is an innovative imaging tool that enables real-time examination of specimens and may be used in evaluating fungal infections. We aimed to assess the applicability of ex vivo CLSM in the diagnosis of onychomycosis by comparing results to those obtained by histopathology, potassium hydroxide (KOH) examination, and fungal culture. In this prospective study, 57 patients with the clinical diagnosis of distal nail fungal infection were examined and compared using all four of the above-mentioned diagnostic tools in terms of sensitivity, positive and negative predictive value. Ex vivo CLSM showed the highest sensitivity, followed by KOH examination, histopathology and fungal culture. Regarding positive and negative predictive values, ex vivo CLSM was superior and showed even higher sensitivity than the combined gold standard comprised of KOH examination, fungal culture or histopathology. |
| Author | Ruini, Cristel French, Lars E. Krammer, Christian Vladimirova, Gabriela Sattler, Elke Hartmann, Daniela Salzer, Suzanna Krammer, Sebastian |
| AuthorAffiliation | Department of Dermatology and Allergy, University Hospital, LMU Munich , Munich , Germany |
| AuthorAffiliation_xml | – name: Department of Dermatology and Allergy, University Hospital, LMU Munich , Munich , Germany |
| Author_xml | – sequence: 1 givenname: Sebastian surname: Krammer fullname: Krammer, Sebastian – sequence: 2 givenname: Christian surname: Krammer fullname: Krammer, Christian – sequence: 3 givenname: Gabriela surname: Vladimirova fullname: Vladimirova, Gabriela – sequence: 4 givenname: Suzanna surname: Salzer fullname: Salzer, Suzanna – sequence: 5 givenname: Cristel surname: Ruini fullname: Ruini, Cristel – sequence: 6 givenname: Elke surname: Sattler fullname: Sattler, Elke – sequence: 7 givenname: Lars E. surname: French fullname: French, Lars E. – sequence: 8 givenname: Daniela surname: Hartmann fullname: Hartmann, Daniela |
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| Cites_doi | 10.1002/jbio.201800391 10.3109/13693781003743130 10.1016/j.jaad.2006.03.033 10.1111/myc.12396 10.1016/j.jid.2019.07.052 10.1111/j.1439-0507.2012.02198.x 10.1002/jbio.201700211 10.1111/ced.12593 10.1002/jbio.201500335 10.1016/S0190-9622(00)90128-2 10.1016/j.jaad.2018.03.062 10.1111/exd.13754 10.1016/j.jaad.2014.02.020 10.1111/jdv.12557 10.1046/j.1365-2133.2003.05029.x 10.1016/S0190-9622(99)70047-2 10.1002/jbio.201700318 10.1111/jdv.12330 10.1309/eph2tdt8335gh0r3 10.1067/S0190-9622(03)01480-4 10.5958/2394-5478.2015.00004.7 10.1111/myc.12097 10.5826/dpc.0802a08 10.1007/s10103-016-2043-3 10.1186/s12879-017-2258-3 10.1007/s00105-015-3607-z 10.2165/00128071-200001010-00002 10.1002/jbio.201800062 10.1111/ced.12546 |
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| Copyright | 2020. This work is licensed under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License. Copyright © 2020 Krammer, Krammer, Vladimirova, Salzer, Ruini, Sattler, French and Hartmann. Copyright © 2020 Krammer, Krammer, Vladimirova, Salzer, Ruini, Sattler, French and Hartmann. 2020 Krammer, Krammer, Vladimirova, Salzer, Ruini, Sattler, French and Hartmann |
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| SubjectTerms | ex vivo fluorescence confocal microscopy Histopathology Infectious diseases KOH examination Lasers Medicine Microscopy mycological examination onychomycosis PAS staining Patients |
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| Title | Ex vivo Confocal Laser Scanning Microscopy: A Potential New Diagnostic Imaging Tool in Onychomycosis Comparable With Gold Standard Techniques |
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