How is confirmation of fungus done?

• Confirmation of fungus in the affected nail is necessary before oral antifungal treatment May mimic other conditions (e.g. psoriasis) – Methods for confirming fungus: Fungal culture is preferred because identification of organism can help direct therapy – KOH exam of fine curetting of subungual fragments – Nail clippings or nail biopsy submitted for histologic exam with fungal stains