Dermoscopic evaluation of nail psoriasis: a cross-sectional study

Authors

  • Krishnendra Varma Department of Dermatology, Venereology and Leprology, R. D. Gardi Medical College, Ujjain, Madhya Pradesh, India
  • Ujjwal Kumar Department of Dermatology, Venereology and Leprology, R. D. Gardi Medical College, Ujjain, Madhya Pradesh, India
  • Praneeta Jain Department of Dermatology, Venereology and Leprology, R. D. Gardi Medical College, Ujjain, Madhya Pradesh, India http://orcid.org/0000-0002-1651-7704

DOI:

https://doi.org/10.18203/issn.2455-4529.IntJResDermatol20205595

Keywords:

Dermoscopy, Nail, Nail psoriasis, Onychoscopy

Abstract

Background: Psoriasis is a chronic inflammatory immune mediated disease that can involve skin, nails, scalp, etc. Nails can be involved in up to 90% of psoriatic patients in their lifetime. Also, psoriatic arthritis is commonly found in patients having nail involvement. Nail changes in psoriasis can be imperceptible to the unaided eye and easily missed on clinical examination. Onychoscopy has helped in improving diagnosing these subtle clinical features. Aim of the research was to study dermoscopic features in nails involved in psoriasis.

Methods: 50 patients having clinically evident nail psoriasis, of which 2 were excluded due to positive KOH examination were recruited in the cross-sectional descriptive study. After clinical examination, all the nails were subjected to dermoscopic examination. The findings were tabulated in Excel and comparisons were made.

Results: The common dermoscopic findings were pits (79.2%), splinter haemorrhage (72.9%), onycholysis (68.8%), subungual hyperkeratosis (50%), nail plate scales (50%), dilated PNF/LNF capillaries (20.8%), ridges (18.8%), leukonychia (14.5%), salmon spots (10.4%), fuzzy lunula (8.3%), and dilated hyponychial capillaries (6.3%).

Conclusions: Dermoscopy is a simple, easy, rapid and an office-based technique. It helps in picking up subtle nail changes not visible to the naked eye. It also precludes from doing painful nail biopsy in nail disease without its skin manifestation. Onychoscopy helps in picking up early nail findings in psoriasis and thereby warning the patients against impending disease severity.

References

Klaassen KMG, van de Kerkhof PCM, Pasch MC. Nail psoriasis: a questionnaire‐based survey. Br J Dermatol. 2013;169(2): 314-9.

Baran R. The burden of nail psoriasis: an introduction. Dermatology. 2010;221(1):1-5.

Wanniang N, Navya A, Pai V, Ghodge R. Comparative Study of Clinical and Dermoscopic Features in Nail Psoriasis. Indian Dermatol Online J. 2020;11(1):35-40.

Chauhan A, Singal A, Grover C, Sharma S. Dermoscopic Features of Nail Psoriasis: An Observational, Analytical Study. Skin Appendage Disord. 2020;6(4):207-15.

Yorulmaz A, Artuz F. A study of dermoscopic features of nail psoriasis. Postep Dermatologii Alergol. 2017;34(1):28-35.

Polat A, Kapıcıoğlu Y. Dermoscopic findings of psoriatic nail and their relationship with disease severity. Turkderm. 2017;51(4):119-23.

Choi JW, Kim BR, Seo E, Youn SW. Identification of nail features associated with psoriasis severity. J Dermatol. 2017;44(2):147-53.

Lencastre A, Lamas A, Sa D, Tosti A: Onychoscopy. Clin Dermatol. 2013;31:587-93.

Iorizzo M, Dahdah M, Vincenzi C, Tosti A. Videodermoscopy of the hyponychium in nail bed psoriasis. J Am Acad Dermatol. 2008;58:714-5.

Errichetti E, Zabotti A, Stinco G, Quartuccio L, Sacco S, De Marchi G, et al. Dermoscopy of nail fold and elbow in the differential diagnosis of early psoriatic arthritis sine psoriasis and early rheumatoid arthritis. J Dermatol. 2016;43(10).

Downloads

Published

2020-12-24

Issue

Section

Original Research Articles