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Dermoscopy of nonpigmented nail lesions

Antonella Tosti, MD
Section Editor
Hensin Tsao, MD, PhD
Deputy Editor
Rosamaria Corona, MD, DSc


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 [1].

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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Literature review current through: Nov 2017. | This topic last updated: Nov 03, 2016.
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