LAUSR

Diagnosis of toenail onychomycosis is based in current practice on direct microscopic examination (DME) and fungal cultures of nail samples.1,2 In 2014, the American Academy of Dermatology's2 reinforced the recommendation for confirmatory testing of onychomycosis before systemic therapy. Although direct microscopic examination (DME) and fungal culture are still recommended in first intention,3 DME requires experience and lacks specificity because it does not provide genus or species of causal fungi. Culture in fungal media lacks sensitivity and takes about 3 weeks to provide results.