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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Bibliographic Details
Published in:Frontiers in medicine Vol. 7; p. 586648
Main Authors: Krammer, Sebastian, Krammer, Christian, Vladimirova, Gabriela, Salzer, Suzanna, Ruini, Cristel, Sattler, Elke, French, Lars E., Hartmann, Daniela
Format: Journal Article
Language:English
Published: Lausanne Frontiers Media SA 06.11.2020
Frontiers Media S.A
Subjects:
ex vivo
fluorescence confocal microscopy
Histopathology
Infectious diseases
KOH examination
Lasers
Medicine
Microscopy
mycological examination
onychomycosis
PAS staining
Patients
Germany
ISSN:2296-858X, 2296-858X
Online Access:Get full text
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Summary: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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Edited by: Ralf J. Ludwig, University of Lübeck, Germany
Reviewed by: Neil H. Shear, University of Toronto, Canada; Katja Bieber, University of Lübeck, Germany
This article was submitted to Dermatology, a section of the journal Frontiers in Medicine
ISSN:2296-858X
2296-858X
DOI:10.3389/fmed.2020.586648