GMS is superior to PAS for diagnosis of onychomycosis

Zandra D'Hue, Susan M. Perkins, Steven D. Billings

Research output: Contribution to journalArticle

25 Scopus citations


Background: Onychomycosis is a common cause of deformed nails. Periodic acid-Schiff (PAS) stains are more sensitive than fungal cultures for diagnosing onychomycosis. We performed a retrospective study comparing the use of PAS and Gomori methenamine silver (GMS) stains for histopathologic diagnosis of onychomycosis. Methods: GMS stains were performed on 20 PAS-positive and 51 PAS-negative cases from nail biopsies with a clinical diagnosis of onychomycosis. The PAS stained slides and GMS stained slides were evaluated for the presence offungal hyphae. The results were analyzed with McNemar's test. Results: All 20 PAS-positive cases were also positive with GMS stains. Of the 51 PAS-negative cases, GMS stains detected an additional five cases with fungal hyphae. GMS stains were quantitatively superior (p < 0.0253). GMS stains were also qualitatively superior. More fungal hyphae were highlighted and fungal hyphae were more easily recognized on low or medium power magnification. Conclusions: GMS stains are superior to PAS stains for the routine diagnosis of onychomycosis.

Original languageEnglish (US)
Pages (from-to)745-747
Number of pages3
JournalJournal of Cutaneous Pathology
Issue number8
StatePublished - Aug 1 2008

ASJC Scopus subject areas

  • Pathology and Forensic Medicine
  • Histology
  • Dermatology

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