Thermography for screening for onychomycosis

NewsBot · Oct 16, 2014

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Screening for tinea unguium by thermography in older adults with subungual hyperkeratosis.
Miura Y, Takehara K, Nakagami G, Amemiya A, Kanazawa T, Kimura N, Kishi C, Koyano Y, Tamai N, Nakamura T, Kawashima M, Tsunemi Y, Sanada H.
Geriatr Gerontol Int. 2014 Oct 14.

AIM:
The purpose of the present study was to assess the difference in foot temperature between tinea unguium-positive older adults with subungual hyperkeratosis and tinea unguium-negative older adults with subungual hyperkeratosis to develop a temperature-based screening method for tinea unguium.
METHODS:
The present cross-sectional, observational study investigated 51 residents with subungual hyperkeratosis in two facilities covered by long-term care insurance between October 2011 and December 2011. One dermatologist recorded the clinical signs of abnormal toenails. Nail specimens were collected from all abnormal nails, and the presence of tinea unguium was confirmed when fungus was detected by direct microscopy. Foot temperature was measured by infrared thermography. A receiver operating characteristic curve was used to assess the ability to determine whether residents with subungual hyperkeratosis have tinea unguium and to determine the cut-off point.
RESULTS:
Among the people with subungual hyperkeratosis, the mean toe temperature in the tinea unguium-positive group (30.2 ± 2.6°C) was significantly lower than that in the tinea unguium-negative group (32.8 ± 3.2°C, P = 0.001). The area under the receiver operating characteristic curve was 0.74 (95% confidence interval 0.621-0.876), and the threshold temperature was set at 33.0°C, resulting in a sensitivity of 81.8% and specificity of 65.7%.
CONCLUSION:
Our study suggests that foot temperature can be used to screen for tinea unguium in people with subungual hyperkeratosis. This non-invasive and simple screening method would help clinicians to set priorities in terms of carrying out direct microscopy to diagnose tinea unguium in elderly residents in care facilities
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NewsBot · Apr 11, 2023

Evaluation of Thermography as a Diagnostic Technique in Asymptomatic or Incipient Onychomycosis
Julia Villar Rodríguez et al
J. Fungi 2023, 9(4), 444;

Onychomycosis is usually diagnosed symptomatically due to the very clear signs caused by the fungus on the nail surface and structure, although the growth of the infecting agent must also be verified by culture in an enriched medium. This procedure is normally lengthy (four weeks), and samples can be contaminated, delaying the prescription of appropriate and effective treatment. Only one previous study has addressed the possibility of using thermography as a diagnostic method for onychomycosis in older people (31–70 years). The present study confirms this use but in individuals aged 18–31 years with incipient mycosis and no pathological signs. Using an FLIR E60 BX camera in a study with 214 samples, we found that men had more onychomycosis than women. We observed a relation between the presence of infection and nail temperature, with a higher temperature in yeast infections (+1 °C) and a lower temperature in dermatophyte infections (−2 °C). A higher temperature by almost 1 °C was also observed in older participants. Thermography can be viewed as a new diagnostic method in asymptomatic or incipient onychomycosis, providing the thermographic camera is sufficiently sensitive and the appropriate procedure is followed, although fungal culture is always necessary to confirm recovery after treatment.
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