Liquid chromatography–mass spectrometry is effective for Analysis of Ergosterol in Fungus Infected Nails

Abstract

Background

The identification of onychomycosis is mainly based on clinical diagnosis with auxiliary diagnostic methods such as KOH microscopy, PAS staining, or mold culture. However, they are limited by the sensitivity and specificity of each type of method. Therefore, our aim is to develop a new test method using the common end product – ergosterol – test to see if it can be used as a new diagnostic tool.

Materials and Methods

We collected consecutive data from 20 subjects with nail problems. After the clinical diagnosis, the subjects received a KOH microscopy test and the extraction of specimens for the mass spectrometer test to check for the presence of ergosterol.

Results

Among the 20 cases collected, seven came out positive by the mass spectrometry test. Four of them were suspected as onychomycosis, whereas one of the remaining three subjects was presumed to be dry nail and the other two as onycholysis. It is obvious that it is easier for the mass spectrometer test to find composites.

Conversely, among the five clinically diagnosed onychomycosis, four came out positive by mass spectrometer whereas the other one was detected negative by KOH and mass spectrometer. Three other subjects were positive with KOH test with mass spectrometer test also resulting to be positive.

Conclusion

The detection of the presence of ergosterol by a mass spectrometer is one of the good tools for confirming onychomycosis. However, there is a need to conduct studies to verify the sensitivity and specificity of the mass spectrometer method.

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