Dermoscopy of nonpigmented nail lesions
- Antonella Tosti, MD
Antonella Tosti, MD
- Professor of Clinical Dermatology
- Department of Dermatology and Cuteneous Surgery, Miller School of Medicine, University of Miami
Nail dermoscopy, also known as onychoscopy, is a useful technique that complements the clinical examination in the evaluation of numerous nail conditions, including nail pigmentations; melanocytic and nonmelanocytic nail tumors; and inflammatory, traumatic, and infectious disorders .
This topic will discuss the dermoscopic features of nonpigmented nail lesions. The dermoscopic features of nail pigmentations are discussed separately. Nail disorders are also discussed separately. (See "Dermoscopy of nail pigmentations" and "Overview of nail disorders".)
The dermoscopic examination of the nail plate and periungual tissues can be performed using both polarized and nonpolarized instruments. (See "Overview of dermoscopy", section on 'Types of dermatoscopes'.)
Nonpolarized contact dermoscopy of the nail plate requires the use of ultrasound gel as an interface medium, as it allows a better contact with the convex nail surface. For the examination of the free nail edge, gel or alcohol can be used as the interface medium. Alcohol is suitable for the evaluation of the proximal and lateral nail folds and hyponychium.
Areas to be examined include the nail plate, the nail plate free edge, the hyponychium, and the nail folds (picture 1 and figure 1). Dermoscopy can also be utilized intraoperatively to assess the morphology and margins of the lesion and optimize excision. Intraoperative dermoscopy is usually performed with polarized instruments.
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- NONMELANOCYTIC NAIL TUMORS
- Glomus tumor
- Digital myxoid cysts
- Pyogenic granuloma
- Bowen disease and squamous cell carcinoma
- DIFFERENTIAL DIAGNOSIS OF ONYCHOLYSIS
- Onycholysis of the fingernails
- - Psoriatic onycholysis
- - Hemorrhagic onycholysis
- - Pseudomonas colonization
- Onycholysis of the toenails
- - Onychomycosis
- - Traumatic onycholysis
- SELF-INDUCED NAIL DISORDERS
- SUMMARY AND RECOMMENDATIONS