Introduction
Nail diseases may often possess a challenge for the treating dermatologist, as they may primarily be affected without any skin involvement and sometimes may present with subtle changes which can be easily missed by the naked eye. The macroscopic nail changes can be assessed very well with a naked eye, however, the important minutiae may be assessed with a dermoscope.
Aim
To study the characteristic dermoscopic findings in various nail diseases.
Materials and methods
A total of 250 patients (males-130, females-120) with clinically evident nail diseases were enrolled in this cross-sectional descriptive study. After a thorough clinical examination, patients were subjected to dermoscopic examination of all 20 nails. Chi-square test or Fisher's exact test (in a very few patients of nail diseases) were used for statistical analysis, with a significance threshold of p < 0.05.
Results
Nail psoriasis (n = 45) was the commonest nail disease found in which the most common dermoscopic feature was circular punctate depressions (64.5%). Onychomycosis (n = 40) was the next common disease in which yellowish discoloration (100%) was commonly seen in all patients and rough scaly surface (100%) in the total dystrophic type. In pitted keratolysis (n = 19) transverse brown bands (57.9%) were most commonly seen as was the case in eczemas. Lichen planus (n = 14) was associated with longitudinal fissuring (64.3%) most commonly. Trachyonychia (n = 5) was associated with longitudinal fissuring (100%) in all cases. The most common dermoscopic feature of alopecia areata (n = 4) was circular punctate depressions (75%). Systemic scleroderma (n = 4) typically showed giant capillaries (75%) as the most common feature.
Conclusion
A meticulous search with the dermoscope, furnishes minuscule details of the nail unit that can be diagnostic of several nail diseases at an early stage before dystrophy sets in. However, further studies are required to validate these findings.
Clinical significance
Dermoscopy is a noninvasive complementary tool which aids in diagnosis of nail diseases more quickly and can also be used for monitoring the evolution, therapeutic response, and prognosis of these diseases.
How to cite this article
Rathod D, Makhecha MB, Chatterjee M, Singh T, Neema S. A Cross-sectional Descriptive Study of Dermoscopy in various Nail Diseases at a Tertiary Care Center. Int J Dermoscop 2017;1(1):11-19.
Numerous studies have demonstrated that the pigmentation of iris and around the eyelid is a common side effect of latanoprost, a prostaglandin F2alpha analogue used in the treatment of glaucoma. Hence, the authors decided to study the effectiveness of topical latanoprost on vitiligo patches around the eyelid. In this randomized, double-blind, clinical trial study, 31 patients with vitiligo vulgaris and focal vitiligo involving the eyelids were evaluated. Patients were randomly divided into two groups. First group received topical latanoprost gel twice daily for 12 weeks, whereas the second group received placebo with the same protocol. To evaluate severity of the disease the VIDA rating system was used. Serial photos of the patches were taken to compare and evaluate the repigmentation percentage of the patches. The patients in both groups had almost similar VIDA score (p > .05). First group showed improved pigmentation, whereas participants in the second group did not show any improvement in the pigmentation. The group treated with latanoprost showed significant reduction in the symptoms of the disease, whereas those treated with placebo did not show any alteration (p > .05). No significant complications were observed in either groups. Latanoprost proved effective in treating vitiligo disease involving eyelids.
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