Nail psoriasis or trachyonychia? Can dermoscopy differentiate them?

Area of Science:

• Dermatology
• Nail Diseases
• Medical Imaging

Background:

• Trachyonychia affects the nail matrix, presenting as opaque or shiny.
• It is often idiopathic but can associate with alopecia areata (AA), psoriasis, and lichen planus.
• Diagnosing isolated nail psoriasis (NP) can be challenging due to its mimicry of trachyonychia.

Purpose of the Study:

• To present two cases of trachyonychia.
• To highlight dermoscopy findings in trachyonychia associated with psoriasis and AA.
• To explore potential diagnostic markers and etiological links.

Main Methods:

• Case report of two patients with trachyonychia.
• Clinical examination and dermoscopy of the nails.
• Literature review on trachyonychia, psoriasis, and AA.

Main Results:

• Both patients exhibited jagged erythema.
• Teardrop-shaped spots on the lunula were observed in both cases, a novel finding in trachyonychia.
• Dermoscopy aided in characterizing nail changes.

Conclusions:

• Jagged erythema and lunula teardrop spots are potential dermoscopic markers for trachyonychia.
• These findings suggest a link between nail matrix inflammation and trachyonychia.
• Further research is needed to confirm these observations and their diagnostic utility.