Onychoscopic evaluation of various nail disorders at a Tertiary care center

Background : Nail diseases have always been a challenge for dermatologists. Because diagnosis is not always based on clinical examination and time taken for histopathology KOH or culture examination is long, there has always been a quest for easy and faster method. Onychoscopy, a rapid office-based technique helps see miniscule details, can hence aid in diagnosis. Aim : To study dermoscopic features in various nail disorders. Materials and Methods : 126 patients with clinically evident nail diseases were recruited in the crosssectional descriptive study. After clinical examination, all nails were subjected to dermoscopic examination. Fischer’s exact test was applied with a significance threshold of p Results : Onychomycosis (n=49) was the commonest nail disorder having spiked pattern as the most common (91.8%) dermoscopic feature. Nail psoriasis (n=32) had onycholysis (84.4%) as the most frequent feature. Nail lichen planus (n=5) had longitudinal fissures (80%) while chronic paronychia (n=5) had erythema and scaling on the PNF (100%). Longitudinal melanonychia (n=5) was associated with regular parallel grey/ brown lines in all cases while trachyonychia had longitudinal ridges in 75% cases. Dilated capillaries (75%), microhemorrhages (75%), capillary dropouts (75%) were seen commonly in systemic sclerosis (n=4). Periungual verruca (n=4) had dermoscopic brownish black dots or globules in 100% cases. Alopecia areata (n=4) showed superficial small pits (100%) most commonly. Conclusion : Dermoscopy helps in picking minute details not visible to the naked eye and hence could serve as an important diagnostic tool. Keywords: Dermoscopy, Longitudinal melanonychia, Nail, Nail lichen planus, Nail psoriasis, Onychomycosis, Onychoscopy, Scleroderma.