Screening for tinea unguium by thermography in older adults with subungual hyperkeratosis
Screening for tinea unguium by thermography in older adults with subungual hyperkeratosis
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DOI：
10.1111/ggi.12380
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发表时间：
2015-08-01
影响因子：
3.3
通讯作者：
Sanada, Hiromi
中科院分区：
文献类型：
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作者：
Miura, Yuka;Takehara, Kimie;Sanada, Hiromi
目的本研究的目的是评估甲癣阳性的甲下角化过度老年人和甲癣阴性的甲下角化过度老年人之间足部温度的差异，以开发一种基于温度的甲癣筛查方法。 方法本横断面观察性研究调查了 2011 年 10 月至 12 月期间在两个长期护理保险覆盖的机构中患有甲下角化过度的 51 名居民2011年，一位皮肤科医生记录了脚趾甲异常的临床症状。从所有异常指甲中采集指甲标本，通过直接显微镜检测真菌来证实甲癣的存在。通过红外热成像技术测量足部温度。采用接受者操作特征曲线来评估判断甲下角化过度居民是否患有甲癣的能力，并确定切点。结果在甲下角化过度人群中，甲癣阳性组的平均脚趾温度（30.22.6℃）显着低于甲癣阴性组的平均脚趾温度（32.8+/-3.2℃， P=0.001）。受试者工作特征曲线下面积为0.74（95%置信区间为0.621-0.876），阈值温度设定为33.0℃，敏感性为81.8%，特异性为65.7%。结论我们的研究表明，足部温度可用于筛查甲下角化过度患者的甲癣。这种非侵入性且简单的筛查方法将帮助临床医生在进行直接显微镜检查以诊断护理机构中老年居民的甲癣方面确定优先顺序。老年老年国际 2015； 15：991-996。
AimThe 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.MethodsThe 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.ResultsAmong the people with subungual hyperkeratosis, the mean toe temperature in the tinea unguium-positive group (30.22.6 degrees C) was significantly lower than that in the tinea unguium-negative group (32.8 +/- 3.2 degrees 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 degrees C, resulting in a sensitivity of 81.8% and specificity of 65.7%.ConclusionOur 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. Geriatr Gerontol Int 2015; 15: 991-996.