Dermoscopy to Detect Signs of Subclinical Nail Involvement in Chronic Plaque Psoriasis: A Study of 68 Patients

Tulika A Yadav, Uday S Khopkar, Tulika A Yadav, Uday S Khopkar

Abstract

Background: Onychopathies constitute one of the major challenges faced by a dermatologist in terms of its early detection and diagnosis. Utility of dermoscope as a tool for detection is increasing by the day and its use in onychopathies needs to be explored.

Aims: To study the dermoscopic features of nails in patients of chronic plaque psoriasis.

Materials and methods: In a cross-sectional study, a total of 68 patients with chronic plaque psoriasis were recruited. Dermoscopy of nail plate was conducted and were compared with equal number of age and sex matched healthy volunteers.

Results: Forty-six patients showed dermoscopic findings. Twenty-two patients did not show any dermoscopic findings. Coarse pits (18/46, P < 0.0001), onycholysis (10/46, P < 0.001), oil drop sign (2/46, P = 0.12) and splinter hemorrhages (5/46, P = 0.05) were seen. In addition certain findings of interest were stout, globose, dilated, pink- to red-colored nail bed vessels arranged longitudinally at the onychodermal band surrounded by a prominent halo (9/46, P = 0.01). In contrast, splinter hemorrhages appeared as streaks and were purple in color.

Conclusion: In a psoriasis patient, dermoscope can be a useful tool to detect early nail involvement in psoriasis and aid in differentiating it from other disorders of nails.

Keywords: Dermoscopy; nail; psoriasis.

Conflict of interest statement

Conflict of Interest: Nil.

Figures

Figure 1
Figure 1
Coarse irregular pits of various sizes and shapes (40x)
Figure 2
Figure 2
Onycholysis occurring at the distal lateral border
Figure 3
Figure 3
Onycholysis appearing as reddish orange discoloration through a video dermoscope (40x)
Figure 4
Figure 4
Dilated globose vessels at the onychodermal band (20x) through a contact dermoscope
Figure 5
Figure 5
Dilated vessels with a prominent halo as seen through a non-contact dermoscope in a polarized light (40x)
Figure 6
Figure 6
Splinter hemorrhages appearing as purple-colored streaks (40x)

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