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NAIL PLATE DAMAGE INDEX IN DERMATOSCOPIC EXAMINATION OF PATIENTS WITH ONYCHOMYCOSIS
G Chekhovska1, N Pustova2, O Syzon3
11Private Institution of Higher Education "Kharkiv Institute of Medicine and Biomedical Sciences", Kharkiv, Ukraine.
Introduction:
The lack of uniform criteria for assessing the degree of damage to the nail plates of patients with onychomycosis does not allow for an objective assessment of the effectiveness of therapy and a comparative assessment of the results of treatment using different methods. In modern medicine, the use of instrumental methods of diagnosis and treatment is becoming more widespread. In particular, one of the options for obtaining information about the state of lesions is nail plate damage index (NPDI). However, the correspondence of the macroscopic appearance to the actual condition remains unclear.
Aim:
The aim of our study was to determine the objectivity of nail plate damage index by comparing it with the degree of contamination with fungal structures.
Material And Methods:
Patients with onychomycosis were examinated with nail plate damage index (NPDI), Scoring Clinical Index of Onychomycosis (SCIO), and Onychomycosis Severity Index (OSI). To assess the degree of fungal contamination, scraping microscopy was performed. After assessing the degree of damage using NPDI, SCIO, OSI compared their results with the data of microscopic examination.
Results:
When comparing the data of microscopic examination and external examination, it was found that, as a rule, with microscopic damage to 25% of the area, macroscopically observed change in nail color is observed, white or yellow spots/stripes appear (often near the free edge or on the sides), while the thickness of the nail is almost not disturbed. With damage from 25% to 50% of the area, the nail becomes dull, noticeably thickens, deforms and begins to crumble. Subungual hyperkeratosis (accumulation of horny masses) often occurs. With damage to more than 50% of the area, changes reach the matrix (nail growth zone). The nail plate collapses, exfoliates from the bed (onycholysis) or becomes thin and softened.
Conclusions:
Definition of nail plate damage indexatonychomycosis is an informative indicator with a high correlation with the area of contamination (r=0.81) and can be recommended for both diagnosis and monitoring of the treatment process.
