ABSTRACT
Dermatophytosis of the scalp, glabrous skin and nails is caused by a closely related group of fungi known as dermatophytes which have the ability to utilise keratin as a nutrient source, i.e. they have a unique enzymatic capacity. It is important to stress that fewer than 50% of dystrophic nails are of fungal aetiology and that it is therefore essential to establish a correct laboratory diagnosis by microscopy and/or culture before treating a patient with a systemic antifungal agent. For a laboratory diagnosis, clinicians should be aware of the need to generate an adequate amount of suitable clinical material. In patients with suspected dermatophytosis of the nails, the nail plate should be pared and scraped using a blunt scalpel until the crumbling white degenerating portion is reached. Therefore, it is essential to perform both direct microscopy and culture on all specimens, and repeat collections should always be considered in cases of suspected dermatophytosis with negative laboratory reports.
