Dermoscopic Features of Nail Psoriasis: An Observational, Analytical Study

Overview

Journal Skin Appendage Disord

Specialty Dermatology

Date 2020 Sep 9

PMID 32903967

Citations 8

Authors

Ankita Chauhan

Archana Singal

Chander Grover

Sonal Sharma

Affiliations

Soon will be listed here.

Abstract

Introduction: Nail involvement in psoriasis occurs in up to 30-50% of patients, and 5-10% may have isolated nail disease. Onychoscopy, a noninvasive tool, might obviate the need for nail biopsy, which is a diagnostic gold standard.

Objective: The aim of this study was to evaluate onychoscopic features of nail unit in patients with nail psoriasis.

Methods: Fifty-five patients with clinically diagnosed and histologically documented nail psoriasis were recruited. Onychoscopy was performed for each nail (excluding the 5th toenail). Clinically, 443/550 fingernails and 101/440 toenails were involved. The frequency distributions of various onychoscopic features was assessed and compared using the χ test ( value <0.05 was considered significant).

Results: With onychoscopy, additional 52 fingernails and 64 toenails showed psoriatic involvement. Pitting was the commonest finding in fingernails (60.5%) followed by subungual hyperkeratosis (SUH) (52.8%), onycholysis (40.8%), and dotted capillaries in hyponychium, proximal, and lateral nail folds (38.6 vs. 35.8 vs. 35.8%). In toenails, we observed SUH (85.1%), nail plate thickening (82.1%), onycholysis (77.2%), and dotted capillaries in hyponychium and nail folds (59.4 vs. 53.4 vs. 45.5%). Fuzzy lunula was a novel onychoscopic finding noted in 33.6% fingernails and 4.95% toenails ( < 0.00001).

Limitations: Small sample size.

Conclusions: Onychoscopy may aid in diagnosing nail lesions even before the clinical signs are apparent.

Citing Articles

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Combined fractional CO2 laser 10,600 nm with methotrexate 1% gel versus methotrexate 1% gel alone in the treatment of nail psoriasis: a randomized comparative study.

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Nejad K, Eftekhari H, Rafiei R, Darjani A, Alizadeh N, Ghadarjani R Heliyon. 2024; 10(8):e29608.

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Dermoscopic Features of Psoriatic Nails and Their Correlation to Disease Severity.

Mashal Z, Elgamal E, Zaky M, Elsaie M Dermatol Res Pract. 2023; 2023:4653177.

PMID: 37223320 PMC: 10202600. DOI: 10.1155/2023/4653177.

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