This prospective observational study assessed dermatophytes in clinically unaffected nails from 120 patients who tested positive for skin dermatophytosis on potassium hydroxide (KOH) examination. Nail clippings underwent KOH microscopy, PCR, and fungal culture using Sabouraud dextrose agar (SDA) and dermatophyte test medium (DTM). Nail KOH testing detected dermatophytes in 39 patients (32.5%), while culture identified growth in 44 patients. Isolates included Trichophyton mentagrophytes (15.1%), T. rubrum (12.1%), T.

tonsurans (4.2%), and unidentified dermatophytes (2.4%). PCR detected dermatophytes in 57 patients (47.5%). Compared with PCR, KOH testing showed 68.4% sensitivity, 100% specificity, 100% positive predictive value (PPV), 77.8% negative predictive value (NPV), and 85% accuracy. Culture versus PCR showed 77.2% sensitivity, 96.8% specificity, 95.7% PPV, 82.4% NPV, and 87.5%…