The dermoscopic manifestation of nail pigmentation

Abstract

Background and objectives: Nail pigmentations are of diagnostic challenging for dermatologists, as they may be involved in many local and systemic diseases that difficult to diagnose clinically. Our aim is to assess the specific dermoscopic features of different pigmented nail lesions.

Methods: In our cross-sectional descriptive study; the total number of 46 patients with different types of nail pigmentation from all age groups and both sexes were included.

Results: A total number of 46 patients, fungal melanonychia (n=14) was the commonest nail pigmentation found. In which the most common dermoscopic features were wide yellow streaks (100%). In drug-induced pigmentation (n=9) fine regular grey lines on a homogenous grey background were found. In Subungual hemorrhage (n=7) blood spots was the most common feature (100%). Lentigo (n=4) were associated with thin regular longitudinal grey lines on homogenous brown background. Nail melanocytic nevus (n=3) multiple, regular brown lines on the homogenous brown background was commonly found. In pseudomonal infection (n=5) bright green color mixed with dark green the most obvious feature. In nail-biting and in Laugier-Hunziker syndrome greyish coloration of background with thin longitudinal grey lines was the common feature. In melanoma (n=1) the dermoscopy showed the brown coloration of the nail plate background with irregular brown-black lines.

Conclusions: Onychoscopy is a non-invasive device that collects much information that helping in the diagnosis of nail pigmentation.