Usefulness of dermoscopy in nail psoriasis

Clinical manifestations of nail psoriasis are diverse and depend on the compromised nail apparatus area. When nail involvement concomitantly occurs with skin lesions, the diagnosis is relatively easy. Nonetheless, in patients with nail compromise solely, the diagnosis is challenging. This review aims to present the current evidence on the dermatoscopic features of nail psoriasis. An exhaustive review of the literature was performed. Relevant studies published from May 2005 to May 2022 explaining the detailed dermatoscopic evaluation of the nail apparatus in patients affected with psoriasis were systematically searched for in scientific databases: Lilacs (IBECS) and PubMed. Study quality was assessed by “Quality Assessment of Diagnostic Accuracy Studies”. Overall, onychoscopy is the fundamental diagnostic tool in the clinical evaluation of these patients. It is considered a noninvasive, accessible, and easy procedure during dermatoscopic visits. Onychoscopy not only confirms the clinical suspicion but also, is a useful guide for the treatment selection as it allows a complete evaluation of the nail apparatus. To conclude, we intend to emphasize the onychoscopy evaluation as a routine practice in patients affected with psoriasis and in suspected ones.