Dermoscopy in the Evaluation of Nail Disorders

Abstract

Nail dermoscopy was initially used only in the assessment of nail pigmentation, but now it is widely utilized for the evaluation of many nail disorders. In daily practice, dermoscopy may confirm clinical diagnoses and guides in the management of nail diseases and treatments, permitting a better visualization of symptoms. Dry dermoscopy is required for evaluation of the nail plate surface, while gel as an interface is necessary for assessment of nail pigmentation and onycholysis, as well as for the evaluation of the distal nail margin. In this review, we describe the dermoscopic features of the most important nail disorders, looking at the different areas of the nail. Dermatoscopic changes that usually accompany specific nail diseases are also reviewed.

A novel dermoscopic feature in traumatic onycholysis

“…Generally, dermoscopy also reveals hemorrhagic spots and streaks, which are the main clues of subungual hemorrhage [6][7][8]. Onycholysis and subungual hemorrhage were the main findings in our patients.…”

“…In addition, distal free edge dermoscopy of the right great toenail revealed reddish-black globules, black dots, red and black filamentous structures (Figs. [4][5][6]. Based on history, clinical and dermoscopic findings we made the diagnosis of traumatic onycholysis in both of our patients.…”

“…Whereas, in onychomycosis the line of detachment has a jagged appearance with sharp indentations, which are called as spikes. In psoriasis, the edge of the detachment is surrounded by an erythematous border [6,7].…”

“…Among them traumatic onycholysis is one of the mostly encountered one, which has been defined as the traumatic separation of the nail plate from the nail bed due to disruption of the onychodermal band [1,3,4]. Although history and clinical examination remain fundamental steps, dermoscopy has offered a new approach in the diagnosis of traumatic onycholysis [5][6][7]. Here, we present two cases of traumatic onycholysis with classical and novel dermoscopic features.…”

Chilblain Lupus with Nail Involvement: A Case Report and a Brief Overview

“…In fact, considering the inflammatory role in LE of new microvessel formation and endothelial cell damage, namely angiogenesis, nail fold capillaroscopy is the best method for analyzing these changes. We believe that this noninvasive technique may be very helpful in diagnosis orientation and, correspondingly, in follow-up during the treatment [11]. …”