Abstract :
Context: Nail patterns are one of the most neglected areas in examination of Psoriasis. But specific nali
patterns of different parts of nail units can yield most pathognomic signs which can aide in establishing the
diagnosis of psoriasis. Dermatoscopy is the non invasive tool that can help in detecting the subsurface and
subtle nai patterns hidden to naked eye.
Aims: to study and compare clinical as well as dermatoscopic nail patterns in biopsy proven cases of
psoriasis
Settings and Design: cross sectional and observational study. Patient selection was based on stobe
randomization.
Methods and Material: a cross sectional and observational study was conducted on 37 biopsy proven
cases of psoriasis. Clinical examination and nail dermatoscopy was done on all twenty nails and results
analysed.
Statistical analysis used: SPSS Software 19.0 version. Chi-Square Test,Wilcoxon-Signed Rank Test, stats
were used
Results: Most common finding of nail psoriasis was pitting seen clinically in 51% and dermatoscopicaly
in 70%. In the nail matrix changes, onycholysis and subungual hyperkeratosis was observed clinically
and dermatoscopicaly in 35% and 54% respectively. Oil drop sign was observed to be pathognomic sign
clinically seen clinically and dermatoscopicaly in 10.85 and 29.7% respectively. Most important feature
in nail psoriasis was nail unit capilloroscopy reduced capillary density was seen in and dilated nail bed
capillaries were seen in 59% and 56% respectively.
Conclusion: Nail dermatoscopy cannot be considered a gold standard in diagnosing psoriasis but definitely
should be considered as a non invasive aide in detecting the subtle changes.
Key Messages: Histopathology is the gold standard in diagnosing psoriasis, but nail examination is often
neglected in cutaneous examination hence dermatoscpopy of nail patterns can act as an diagnostic aide in
day to day practise.
Keyword :
Psoriasis, Nail, Dermatoscope, Linkage fluid.