Aldana-Caballero Alberto, Mayordomo Raquel, Marcos-Tejedor Félix
Department of Nursing, Physiotherapy and Occupational Therapy, Faculty of Health Sciences, Universidad de Castilla-La Mancha, 45600 Talavera de la Reina, Spain.
DEDAP Research Group, Department of Anatomy, Cellular Biology and Zoology, Universidad de Extremadura, 10600 Plasencia, Spain.
J Fungi (Basel). 2022 Jan 29;8(2):135. doi: 10.3390/jof8020135.
Onychomycosis and human papillomavirus (HPV) plantar warts are common in clinical practice. Clinical diagnosis is based on searching for pathognomonic signs and symptoms. However, due to misdiagnosis, podiatrists may unnecessarily prescribe antifungal treatments or burn lesions with chemical agents. The objective of this study was to assess podiatrists' visual diagnosis of these infections and their willingness to use complementary tests. A 12-item questionnaire was developed to assess visual diagnostic ability. The diagnoses of all lesions were verified before the questionnaire was sent out. The respondents were 415 podiatrists with a range of years of experience. While 86.3% of podiatrists considered complementary tests for onychomycosis necessary, only 21.4% used them regularly. As many as 60.2% would leave a distal subungual onychomycosis untreated based on visual diagnosis. In the case of HPV, only 14.5% of respondents considered complementary tests necessary, although 76.6% would treat a non-HPV lesion with regular chemical agents. Years of experience did not affect the percentage of misdiagnoses. Complementary tests are needed in clinical practice to avoid unnecessary treatments. Podiatrists easily identify clear signs and symptoms but have difficulty making differential diagnoses. Research should focus on ensuring complementary tests are available to health professionals.
甲癣和人乳头瘤病毒（HPV）引起的跖疣在临床实践中很常见。临床诊断基于寻找特征性体征和症状。然而，由于误诊，足病医生可能会不必要地开抗真菌治疗药物或用化学药剂烧灼病变部位。本研究的目的是评估足病医生对这些感染的视觉诊断能力以及他们使用辅助检查的意愿。设计了一份包含12个条目的问卷来评估视觉诊断能力。在问卷发出之前，对所有病变的诊断进行了核实。受访者为415名具有不同工作年限的足病医生。虽然86.3%的足病医生认为甲癣需要进行辅助检查，但只有21.4%的人经常使用这些检查。多达60.2%的人会根据视觉诊断对远端甲下型甲癣不进行治疗。对于HPV，只有14.5%的受访者认为需要进行辅助检查，尽管76.6%的人会用常规化学药剂治疗非HPV引起的病变。工作年限并未影响误诊率。临床实践中需要辅助检查以避免不必要的治疗。足病医生很容易识别明显的体征和症状，但在进行鉴别诊断时存在困难。研究应侧重于确保卫生专业人员能够获得辅助检查。
