甲屑中过碘酸希夫阳性真菌的组织病理学发现。

Histopathological Findings in Nail Clippings With Periodic Acid-Schiff-Positive Fungi.

机构信息

Department of Dermatology, Rambam Health Care Campus, Israel; and.

The Bruce Rappaport Faculty of Medicine, Rambam Medical Center, Technion, Haifa, Israel.

出版信息

Am J Dermatopathol. 2021 May 1;43(5):338-341. doi: 10.1097/DAD.0000000000001800.

DOI:10.1097/DAD.0000000000001800

PMID:32956097

Abstract

BACKGROUND

Periodic acid-Schiff (PAS) staining of nail clippings is an adjunct diagnostic tool for onychomycosis.

OBJECTIVE

To detect histopathological findings as clues to the presence of PAS-positive (+) fungal elements in nail clippings.

METHODS

Four hundred sixteen consecutive nail clippings suspected of onychomycosis were stained with hematoxylin and eosin, and with PAS stains. All cases were studied histopathologically. The clinical files of the cases with neutrophils were reviewed.

RESULTS

PAS+ staining for fungi were demonstrated in 159 (38%) of the nail clippings. Neutrophils, parakeratosis, plasma globules, and bacteria were observed in 43 (27%), 108 (67%), 80 (50%), and 80 (50%) of the PAS+ cases, respectively, and in 17 (6%), 109 (41%), 84 (32%) and 140 (54%) of the PAS- cases, respectively (P < 0.01). Neutrophils showed by far the highest specificity (93%), although with low sensitivity (27%) for the presence of PAS+ fungi. Among the 43 PAS+ and 17 PAS- specimens with neutrophils, only 1 (2.3%) and 3 (17%) had overt psoriasis, respectively.

CONCLUSION

Neutrophils in nail clippings may serve as a clue for onychomycosis. PAS staining with neutrophils is not necessarily associated with psoriasis.

摘要

背景

指甲屑的过碘酸希夫（PAS）染色是甲真菌病的辅助诊断工具。

目的

检测组织病理学发现，以提示指甲屑中 PAS 阳性（+）真菌元素的存在。

方法

对 416 例连续疑似甲真菌病的指甲屑进行了苏木精和伊红染色以及 PAS 染色。所有病例均进行了组织病理学研究。回顾了有中性粒细胞的病例的临床档案。

结果

指甲屑中有 159 例（38%）显示 PAS+真菌染色。中性粒细胞、角化不良、血浆球和细菌分别在 43 例（27%）、108 例（67%）、80 例（50%）和 80 例（50%）的 PAS+病例中观察到，分别在 17 例（6%）、109 例（41%）、84 例（32%）和 140 例（54%）的 PAS-病例中观察到（P < 0.01）。中性粒细胞的特异性最高（93%），尽管对 PAS+真菌的敏感性较低（27%）。在 43 例 PAS+和 17 例 PAS-有中性粒细胞的标本中，分别只有 1 例（2.3%）和 3 例（17%）有明显的银屑病。