Krammer Sebastian, Krammer Christian, Vladimirova Gabriela, Salzer Suzanna, Ruini Cristel, Sattler Elke, French Lars E, Hartmann Daniela
Department of Dermatology and Allergy, University Hospital, LMU Munich, Munich, Germany.
Front Med (Lausanne). 2020 Nov 6;7:586648. doi: 10.3389/fmed.2020.586648. eCollection 2020.
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 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. CLSM showed the highest sensitivity, followed by KOH examination, histopathology and fungal culture. Regarding positive and negative predictive values, CLSM was superior and showed even higher sensitivity than the combined gold standard comprised of KOH examination, fungal culture or histopathology.
共聚焦激光扫描显微镜（CLSM）是一种创新的成像工具，能够对标本进行实时检查，可用于评估真菌感染。我们旨在通过将结果与组织病理学、氢氧化钾（KOH）检查和真菌培养所获得的结果进行比较，评估CLSM在甲癣诊断中的适用性。在这项前瞻性研究中，对57例临床诊断为远端甲真菌感染的患者进行了检查，并使用上述所有四种诊断工具在敏感性、阳性和阴性预测值方面进行了比较。CLSM显示出最高的敏感性，其次是KOH检查、组织病理学和真菌培养。关于阳性和阴性预测值，CLSM更具优势，其敏感性甚至高于由KOH检查、真菌培养或组织病理学组成的联合金标准。
