Hey Doc,
you have the South Texas Toenail lab guy right here. That's why I'm known as 
"Joe the Toe".
    We soak our nails in 20% ammonium hydroxide for at least an hour before 
we put the blocks on the machine to process. We've been getting nailed for a 
couple of years and perform a PAS for Fungus on each case that we do. 
Reimbursement must be good, we keep getting nailed.

Joe the Toe or just JTT

----- Original Message ----- 
From: 
To: 
Sent: Thursday, February 22, 2007 12:09 PM
Subject: [Histonet] PAS stain for nail fungus


> Dr. Allen Smith's recent post reminds me of a question I've been meaning 
> to post to Histonet.
>
> Podiatrists are now performing biopsies of toenails with nail fungus, in 
> order to get a fungal stain (PAS is being requested, I think) done. 
> Apparently the insurance companies are now requiring a biopsy or culture 
> diagnosis of fungal disease before they'll pay for the very expensive 
> systemic drugs for nail fungus like terbinafine (Lamisil).
>
> Is anyone on Histonet getting these requests? What protocols do you use to 
> cut and stain these difficult specimens?
>
> Bob Richmond
> Samurai Pathologist
> Knoxville TN
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