Diagnostic Applications of Nail Clippings

Trachyonychia: Review and Update on Clinical Aspects, Histology, and Therapy

“…This procedure is noninvasive, bears little to no risk to the patient, and may also provide other clues to the underlying diagnosis. For example, histologic features of nail unit psoriasis may be present [22] in a nail clipping from a patient with idiopathic trachyonychia. …”

Nail clipping with onychomycosis and surprise clue to the diagnosis of nail unit melanoma

“…Nail tumors, such as onychomatricoma and squamous cell carcinoma of the nail unit, are reported in association with onychomycosis, with cases of associated SUM reported only rarely . Nail clipping is a simple diagnostic technique primarily used in clinical practice to obtain evidence of an active fungal infection . Herein, we describe a case of co‐existent onychomycosis and SUM diagnosed after a routine nail clipping was submitted for confirmation of onychomycosis.…”

Acral manifestations of fungal infections

“…PAS and Gomori methenamine silver (GMS) stains should be performed for onychomycosis, because nail unit psoriasis may resemble onychomycosis and fungal hyphae should be shown for proper treatment. 33 If mild to moderate onychomycosis (<50% of distal end affected) is present, topical therapy can be preferred. Two topical medications formulated as lacquers are approved for use in onychomycosis as monotherapies.…”

“…3,17 In In addition to the dermatophytes, non-dermatophyte fungi such as Candida, Aspergillus, Scopulariopsis brevicularis, Scytalidium dimidiatum, and Fusarium are responsible for the infection in 5% to 15% of patients with onychomycosis. 16,33 Aspergillus spp. and Scopulariopsis brevicularis were reported as the most common opportunistic molds in patients with onychomycosis .…”