Onychoscopy: an observational study in 237 patients from the Kashmir Valley of North India

Abstract

Background: Nail disorders comprise approximately 10% of all dermatological conditions. Because diagnosis is not always possible by clinical means alone, additional diagnostic procedures may be required at times. Dermoscopy of nails (onychoscopy) has shown promising results in diagnosing various nail disorders and also avoids time-consuming investigations such as culture and biopsy. Objective: To study the dermoscopic features of various nail disorders to determine the correlation between KOH examination and onychoscopic patterns in patients with the clinical suspicion of onychomycosis, and to differentiate benign pigmented lesions from malignant ones. Methods: An open, observational and cross-sectional study of 237 patients was conducted. All patients underwent clinical examination and the affected nails were examined with a dermatoscope. The onychoscopic patterns were identified and recorded. Results: The study included 237 patients with the following diagnoses: 81 onychomycosis, 63 psoriasis, 27 lichen planus, 30 longitudinal melanonychia, 24 connective tissue disorders, 5 onychophagia and nail tics, 3 subungual verrucae, 2 glomus tumor, 1 Darier disease, and 1 enchondroma. The most common onychoscopic findings were spiked pattern in cases of onychomycosis, dilated and tortuous capillaries in cases of psoriasis, longitudinal streaks and nail fragmentation in cases of lichen planus, and enlarged capillaries in cases of connective tissue diseases. Limitations: The study was only observational and did not compare the results to biopsy and culture. Conclusions: Onychoscopy may be used as an important diagnostic tool when evaluating nail disorders.

Dermoscopy of onycholysis due to nail psoriasis, onychomycosis and trauma: A cross sectional study in skin of color

“…Spiked and jagged edges were the most common finding in our study, which is similar to study by Bhat et al,[ 11 ] and in contrast to other studies where longitudinal streak was the most common finding. [ 12 13 14 ] Spikes are due to the nail anatomy and fungal invasion.…”

Evaluation and comparison of clinical and dermatoscopic nail patterns in psoriasis – an observational study

“…7 In another study conducted by Bhatt YJ et al on dermoscopy of nail findings they found longitudinal and transverse ridging in 85% and 54% cases respectively which is higher than our study. 8 So from our study, we infer that there is not much difference in clinical and dermatoscopic finding in these nail surface changes.…”

Nail Digital Dermoscopy in Onychomycosis: Correlation With Clinical Type, Gender And Culture Examination

“…Nakamura et al performed dermoscopy in 500 cases of nail dystrophies and found chromonychia, onycholysis, opacity, and longitudinal stripes in patients with OM (1). In another study with onychoscopy in 237 patients with nail disorder, OM showed jagged pattern of the proximal margin of the onycholytic area, spikes in the proximal fold, white-yellow longitudinal striae in the onycholytic nail plate, and distal irregular termination pattern (12).…”