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Summary

Dermoscopy reveals distinct nail psoriasis (NP) patterns, aiding diagnosis and psoriatic arthritis risk assessment. A new algorithm may reduce the need for biopsies in identifying NP.

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Area of Science:

Dermatology
Medical Diagnostics

Background:

Nail psoriasis (NP) exhibits diverse morphological patterns crucial for diagnosis.
Dermoscopy is essential for accurately identifying these NP patterns.

Purpose of the Study:

Classify NP into dermoscopic patterns.
Correlate patterns with disease severity and psoriatic arthritis risk.
Develop a pattern-based dermoscopic algorithm for NP diagnosis.

Main Methods:

Prospective study of 208 NP patients and 418 controls.
One-year duration with dermoscopic examination of all nails.

Main Results:

Identified two primary NP dermoscopic patterns: bed and matrix (BM) and trachyonychia.
BM pattern was more common; trachyonychia associated with severe NP and higher psoriatic arthritis risk.
Leukonychia was more frequent in controls.

Conclusions:

Dermoscopy reliably identifies NP patterns, distinguishing it from other nail disorders.
A pattern-based algorithm can aid NP diagnosis, potentially avoiding histopathology.
Dermoscopy is underutilized but highly valuable for NP.