Molecular Genetic Testing (PCR Assay) now available for rapid fungal identification.

Accurate pathogen identification for prompt and targeted anti-fungal treatment.

PCR provides results in 1-2 days!

  • Shown to be twice as sensitive as culture for identifying dermatophytes.
  • Organism identification to complement high sensitivity of PAS/GMS/FM without substantially increasing turn-around-time.
  • As a clinical lab test (such as bloodwork), molecular genetic studies are often paid for in-full by insurers.
  • Organism Genus may be necessary for preauthorization of new topical anti-fungal medications.

SEE BELOW MOLECULAR GENETIC TESTING (PCR ASSAY)

NAIL UNIT TESTING REFERENCE GUIDE

Test Notes
PAS
Periodic acid-Schiff reaction

(dry or formalin)

PAS Periodic acid-Schiff reaction (dry or formalin)
  • Chemical reaction, whereby carbohydrates are oxidized to form aldehydes
  • Aldehydes react with Schiff reagent to produce a magenta color
  • Shows excellent fungal morphology
  • Best for superficial skin/nail infections, which do not disclose abundant acute
    inflammation/suppuration
  • Reacts with most, but not all, fungi and yeast
  • Better at demonstrating non-degenerated organisms
  • High sensitivity (few false negative tests), but rarely organism specific 
GMS
Gomori Methenamine Silver
Silver-based histochemical stain

(dry or formalin)

GMS Gomori Methenamine Silver
  • Stains carbohydrates (sugars)
  • Tissue is pre-treated with chromic acid, then silver is applied
  • Offers high sensitivity, but poor morphology (target acquires a “dirty” granular appearance)
  • Arguably better for fungal infections found in association with abscesses
  • Better visualization of fungal infections in the deep tissues
  • Stains most, but not all, fungi and yeast
  • May excel at staining degenerated organisms
  • In tandem with PAS, highest sensitivity, but not organism specific

Fontana Masson Stain

Silver-based histochemical stain

(dry or formalin)

Fontana Masson Stain
  • Highlights melanin pigment in fungal organisms
  • Large quantities of melanin pigment favors dematiaceous fungi (pigmented saprophytic mold)
  • Deciphers melanin pigment from other pigments (hemosiderin)
  • Validates the presence of an underlying melanocytic process, e.g. benign matrical melanotic macule, nevus, or melanoma
  • Adds specificity (identifies dematiaceous fungi) and screens for pigmented lesions within nail matrix
Molecular Genetic Testing
(PCR Assay)

(dry only)

Molecular Genetic Testing
  • Detects the genetic material of the pathologic fungi (dermatophytes, saprophytes, and/or yeasts)
  • If detected, genes specific for the pathogens genus +/- species are sought
  • Offers 1-2 day turn-around-time, rather than 28 days via culture
  • Compared to culture, offers 25% higher sensitivity than culture overall, and twice its sensitivity when detecting dermatophytes
  • As a clinical lab test (such as bloodwork), molecular genetic studies are often paid for in-full by insurers
  • Organism identification may be necessary for preauthorization of new topical nail anti-fungal products (indicated against Trichophyton Spp only)
  • Augments the superior sensitivity of PAS/GMS, by providing high specificity (organism identification) for targeted patient therapy

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