Comparison of diagnostic methods in onychomycosis and analysis of cost effectiveness

Onychomycosis is one of the most frequent nail diseases. It constitutes approximately 50% of all nail disorders.Onychomycosis generally progress more easily in the presence of one or more of the factors such as elderliness, tinea pedis infection, immunodeficiency, genetic tendency, peripheral neuropathy, peripheral circulatory disorder, foot deformity, diabetes, smoking, narrow shoes and recurring trauma.Onychomycosis is generall asymptomatic. However, cosmetic disorders in the nail can lead to some problems in social and professional life. Moreover, when normal structure of nails deteriorate, it may cause pain, ingrown nails and secondary bacterial infection and may restrict functions of hands and feet. Onychomycosis is a significant disease group as it has a chronic course, resistant to the treatment without spontaneous improvement.In this study, we aimed to compare diagnostic sensitivity rates and cost effectiveness of diagnostic tests in patients admitted with clinical findings that suggest onychomycosis in nails, as well as to evaluate factors affecting onychomycosis and compare our findings with literature findings all around the world.Diagnostic sensitivity rates of the diagnostic tests in 50 cases are as followed; culture made the correct diagnosis for 24 (48%) of 50 cases; standard KOH examination made the correct diagnosis for 34 (68%); 24-hour KOH examination made the correct diagnosis for 40 (80%) and histopathological examinations made the correct diagnosis for PAS 34 (68%). These results are similar to studies conducted in different areas.Considering cost-effectiveness correlation, it is seen that the most costefficient test as well as the most successful test is 24-hour KOH examination whereas the most expensive test is histopathological examinations (PAS-GMS).54Onychomycosis is a widespread disease in our country and in the world. Making the correct diagnosis in time and efficient treatment increases the quality of life of the patients significantly