Study On The Coincidence Degree Of Dermoscopy And Nail Lysate Microscopy In The Diagnosis Of Onychomycosis

Objective:To observe the coincidence degree between the two experimental diagnostic methods of dermoscopy and the nail lysate microscopy for the diagnosis of onychomycosis,and to explore the diagnostic value of dermatoscopy for onychomycosis.Methods:The cases were from 120 patients who were diagnosed as onychomycosis in the dermatology clinic of the First Clinical Medical College of Shanxi Medical University from May 2017 to December 2018.120 cases of nails was treated with double-blind method.Examination of the dermoscopy and the nail lysate microscopy,the results of the diagnosis were compared,the detection rate of the two experimental diagnostic methods for onychomycosis was compared,and the current statistics of the dermoscopic smear of the smear-positive smear analysis.Results:1.χ2=25.628,P=0.021,the difference was statistically significant.It was considered that the detection rate of dermatoscopy on fungi was lower than that of nail lysate microscopy.The sensitivity of dermascopic diagnosis was 88.0%,the specificity was 75.0%,the total coincidence rate was 86.7%,the Kappa value was 0.459,and the r value was 0.488.2.Dermatological manifestations and probabilities of two clinical types of onychomycosis.2.1 General dermoscopic features of distal and lateral subungual onchomycosistype(65 cases): Ruin appearance 60/65(92.3%),Longitudinal striae 58/65(89.2%),Jagged edge 52/65(80.0%),Splinter hemorrhage 10/65(15.4%),Horizontal striae 8/65(12.3%),Lumpy appearance 5/65(7.7%),Thick nail 65/65(100%),Color change 65/ 65(100%),Matte nail 65/65(100%).2.2 General dermoscopic of full nail damaged onychomycosis(43cases):Ruin appearance 35/43(81.4%),Longitudinal striae 35/43(81.4%),Splinter hemorrhage 17/43(39.5%),Lumpy appearance 6/43(13.9%),Thick nail43 /43(100%),Color change 43/43(100%),Matte nail 43/43(100%).Conclusion:Dermatoscopy can be used as a quick and effective diagnostic method for the clinical diagnosis of onychomycosis,and it can be used as a supplement for nail lysate microscopy.Ruin appearance,Longitudinal striae,Jagged edge were characteristic dermoscopy features of it,The Horizontal striae and Lumpy appearanceare were newly discovered types in this experiment.