A Study on Onychoscopic Findings of Various Benign Nail Disorders

Abstract Introduction: Nail disorders comprise approximately 10% of all dermatological conditions. As diagnosis is not always possible by clinical means alone, additional diagnostic procedures may be required at times. Onychoscopy is a valuable aid in enhancing visible nail features and may help in avoiding nail biopsy in unnecessary cases. Aims and Objective: The aim of the study was to determine dermoscopic features of various nail disorders and to correlate dermoscopic findings with the clinical picture. Materials and Methods: The study was conducted in the outpatient department of dermatology, venereology and leprology using a hand-held self-illuminated Dermlite DL4N dermoscope. Various patients with nail disorders were examined clinically, a dermoscopy of nails (onychoscopy) was done and dermoscopy findings were correlated with clinical diagnosis. The photographic documentation of the clinical, as well as the dermoscopic picture, was done. Results: The study included 126 patients with a diagnosis of onychomycosis, psoriasis, lichen planus, eczema, alopecia areata, subungual hematoma and longitudinal melanonychia. The most common onychoscopic finding was onycholysis (92%) with irregular borders (56%) in psoriasis, onycholysis (95%) with spiked pattern (62%) in onychomycosis, longitudinal ridging (62.5%) in lichen planus, uniform-coloured bands in melanonychia, regular pitting (83%) in alopecia areata, brownish discolouration in a subungual hematoma. Conclusions: Onychoscopy is a non-invasive, office-based technique applied for a better understanding of nail pathology and to avoid unnecessary investigations. For some diseases, zooming in adds a lot to clinical examination and reveals suggestive features not otherwise visible to the naked eye.