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Nail Dermoscopy

  • Michela Starace
Chapter

Abstract

Nail dermoscopy was initially used only in the assessment of nail melanocytic lesions, but more recently it is being used for expanded diagnosis of all nail disorders and has become a routine diagnostic instrument. In daily practice, dermoscopy may be a useful tool with which to elucidate common findings about specific diseases in order to reinforce presumptive clinical diagnoses, as well as guide the management and prognoses of different nail diseases. The use of dermoscopy can be applied to all visible parts of the nail unit, but it is also possible to observe the nail matrix, the only non-visible part, in conjunction with intra-operative methods. A good knowledge of the pathogenesis of nail diseases is important in order to know on which part of the nail to focus. The nail is visible as a whole only with 10× magnification, but with a magnification range from 20 to 70×, observation can be improved by moving the lens back and forth and transversally. In most cases nail dermoscopy only permits a better visualization of symptoms already evident to the naked eye. However, in a few diseases, the technique can provide important diagnostic information.

The first part of the chapter, we explain techniques and problems of nail dermoscopy and will help the reader perform this exam on the nails. The second part we show how to identify the normal nail with dermoscopy, followed by sections on the main features of the most commonly encountered nail diseases.

Pictures of the dermoscopic features described in the text are provided, sometimes with the corresponding clinical picture helping to underline the fact the nail dermoscopy is useless without the clinical observation of the signs.

Keywords

Dermoscopy Onychoscopy Capillaroscopy Onycholysis Pitting Dermatomyositis Systemic lupus erythematous Trachyonychia Splinter hemorrhages Discoloration Proximal margin Capillary Color alterations Melanonychia Management 

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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Dermatology, Department of Experimental, Diagnostic and Specialty MedicineUniversity of BolognaBolognaItaly

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