A Cross-sectional Descriptive Study of Dermoscopy in various Nail Diseases at a Tertiary Care Center

Abstract

ABSTRACT Introduction Nail diseases may often possess a challenge for the treating dermatologist, as they may primarily be affected without any skin involvement and sometimes may present with subtle changes which can be easily missed by the naked eye. The macroscopic nail changes can be assessed very well with a naked eye, however, the important minutiae may be assessed with a dermoscope. Aim To study the characteristic dermoscopic findings in various nail diseases. Materials and methods A total of 250 patients (males-130, females-120) with clinically evident nail diseases were enrolled in this cross-sectional descriptive study. After a thorough clinical examination, patients were subjected to dermoscopic examination of all 20 nails. Chi-square test or Fisher's exact test (in a very few patients of nail diseases) were used for statistical analysis, with a significance threshold of p < 0.05. Results Nail psoriasis (n = 45) was the commonest nail disease found in which the most common dermoscopic feature was circular punctate depressions (64.5%). Onychomycosis (n = 40) was the next common disease in which yellowish discoloration (100%) was commonly seen in all patients and rough scaly surface (100%) in the total dystrophic type. In pitted keratolysis (n = 19) transverse brown bands (57.9%) were most commonly seen as was the case in eczemas. Lichen planus (n = 14) was associated with longitudinal fissuring (64.3%) most commonly. Trachyonychia (n = 5) was associated with longitudinal fissuring (100%) in all cases. The most common dermoscopic feature of alopecia areata (n = 4) was circular punctate depressions (75%). Systemic scleroderma (n = 4) typically showed giant capillaries (75%) as the most common feature. Conclusion A meticulous search with the dermoscope, furnishes minuscule details of the nail unit that can be diagnostic of several nail diseases at an early stage before dystrophy sets in. However, further studies are required to validate these findings. Clinical significance Dermoscopy is a noninvasive complementary tool which aids in diagnosis of nail diseases more quickly and can also be used for monitoring the evolution, therapeutic response, and prognosis of these diseases. How to cite this article Rathod D, Makhecha MB, Chatterjee M, Singh T, Neema S. A Cross-sectional Descriptive Study of Dermoscopy in various Nail Diseases at a Tertiary Care Center. Int J Dermoscop 2017;1(1):11-19.