Dermoscopy: the ultimate tool for diagnosis of nail psoriasis? A review of the diagnostic utility of dermoscopy in nail psoriasis

Dermoscopy is a highly practical noninvasive diagnostic tool. Several dermoscopic algorithms have been proposed in the evaluation of skin diseases, which allow clinicians not only to identify and make differential diagnosis, but also to determine the treatment choices in challenging clinical circumstances. Over the years, we have witnessed a rapid increase in the utilization of dermoscopy in the assessment of nail disorders. However, to assess the diagnostic utility of dermoscopy in inflammatory nail diseases, current evidence is insufficient. Nail psoriasis is a significant challenge because of the difficulties in its diagnosis. Detection of nail involvement is of utmost importance in psoriasis because it is highly associated with arthritis, which is an indication for systemic treatment. Dermoscopy holds promise as a potential tool in the diagnosis of nail psoriasis, capable of providing characteristic clinical findings without any delay and discomfort. This review summarizes current evidence regarding the unique dermoscopic features of nail psoriasis. It addresses whether dermoscopy may serve as the gold-standard diagnostic tool, excluding the necessity of histopathological examination for the ultimate diagnosis of nail psoriasis.