44 to 100% for potassium hydroxide (KOH) mount, and about 81 to 91.6% for biopsy. Currently, there is no consensus on the most appropriate combination of tests that can increase the sensitivity and specificity of diagnosis. The sensitivity values reported for test combinations are 57% for biopsy and KOH, and 98.3% for biopsy and culture (2).Onychoscopy is dermoscopic examination of the nail apparatus, which includes the nail plate surface and the free edge, nail matrix, nail bed, periungual folds, and hyponychium. It forms a link between naked eye examination and nail histopathology, opening the potential to prevent biopsy (3).Piracini et al. were the first to use dermoscopy to support the diagnosis of fungal infection of nails. Their retrospective study of 57 patients sought to identify and describe dermoscopic signs specific for distal subungual onychomycosis that could differentiate it from traumatic mycologically negative onycholysis (4).Very few studies are available in the literature on onychoscopic findings of onychomycosis in Indian patients. The aim of this study was to identify common onychoscopic patterns of onychomycosis prevalent in this part of India, explore their correlation with clini-cal subtypes of onychomycosis, and contribute to knowledge of the use of onychoscopy as a simple, quick, and reliable diagnostic aid for clinical diagnosis of onychomycosis in the outpatient department setting. Materials and methodsThis was an outpatient-based, observational, cross-sectional study conducted for 6 months using the STROBE checklist, after obtaining institutional ethical clearance. Patients were recruited after providing informed written consent (in Hindi or English) for inclusion in the study as well as separate consent for photography.The aim of the study was to identify common onychoscopic patterns in nails affected by onychomycosis and to describe their correlation to the clinical subtypes of onychomycosis. The inclusion criteria were all treatment-naive patients presenting to the dermatology outpatient department for the first time and clinically diagnosed with onychomycosis. Children below 18 years, patients already partially treated for onychomycosis, patients with clinical diagnosis of onychomycosis but negative on KOH mount were excluded from the study.Nail clippings of all patients were taken for KOH mounting. Only patients with a positive KOH mount were recruited for the study. Images of the affected nail were obtained with a Canon PowerShot G1x® camera. Onychoscopy was performed with DermLite II hybrid m, 3Gen, polarized mode, 10× magnification. An IPhone camera was used to capture the images. The image from the most clinically dystrophic nail unit, whether fingernail

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Objectives: Alopecia areata (AA) is a common autoimmune hair disorder with variable disease activity and severity. Conventionally, hair pull test (HPT) and off late trichoscopy are used to diagnose and monitor disease course in AA. The aim of the study was to evaluate the use of trichoscope in monitoring the disease activity, severity, and therapeutic response in AA. Material and Methods: This was a hospital-based and longitudinal study. Consecutive patients with AA between March 2018 and February 2019 were included in the study. Baseline clinical examination, HPT, and trichoscopy of patients was done at baseline and adequate treatment initiated. Monthly follow-up for next 3 months was done to study response to treatment. Results: Black dots (BDs) (100%) were commonest trichoscopic feature followed by yellow dots (YDs) (93.5%). BDs, broken hairs (BHs), and short vellus hairs (SVH) had significant correlation with disease activity while all trichoscopic markers significantly correlated with disease severity. With each follow-up, mean values for YDs, BDs, and BHs were declining, while SVH was increasing steadily. The abatement of trichoscopic activity markers preceded the disappearance of a positive HPT. Conclusion: The abatement of trichoscopic markers of disease activity in AA preceded a negative HPT, highlighting the role of trichoscopy as a useful tool in monitoring therapeutic response.