Beyond the Plate: Nail Bed Dermoscopy for Differentiation of Psoriatic, Fungal, and Traumatic Fingernail Onycholysis

Andrea Sechi; Michela Starace; Luca Valtellini; Francesca Pampaloni; Bianca Maria Piraccini; Antonella Tosti; Matilde Iorizzo

doi:10.1111/ijd.70449

May 6, 2026International Journal of Dermatology

Beyond the Plate: Nail Bed Dermoscopy for Differentiation of Psoriatic, Fungal, and Traumatic Fingernail Onycholysis

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Key Points

Investigate whether dermoscopy can distinguish between psoriasis, onychomycosis, and trauma in onycholytic nails without biopsy.
Multicenter retrospective study examining 60 onycholytic fingernails (20 per diagnosis).
Dermoscopy before and after clipping the nail plate, assessing features under dry and wet conditions.
Multinomial logistic regression used to analyze associations between dermoscopic features and diagnoses.
Psoriasis characterized by high scale amount (65%), white color (95%), and strong adherence (95%).
Onychomycosis indicated by moderate/high scale amount (95%) and yellow/yellow-white color (90%).
Trauma associated with low scale amount (75%), thin scales, and increased odds for reduced adherence (OR 80.95).

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Implication

Retrospective image-based study demonstrates improved differentiation of onycholysis causes using dermoscopy, suggesting enhanced diagnostic accuracy.

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Cite This Study

Sechi et al. (2026) studied this question.

synapsesocial.com/papers/69fd7f0dbfa21ec5bbf07628 https://doi.org/10.1111/ijd.70449

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Beyond the Plate: Nail Bed Dermoscopy for Differentiation of Psoriatic, Fungal, and Traumatic Fingernail Onycholysis

Key Points

No abstract yet

Implication

Discussion

Cite This Study

Beyond the Plate: Nail Bed Dermoscopy for Differentiation of Psoriatic, Fungal, and Traumatic Fingernail Onycholysis

Key Points

No abstract yet

Implication

Discussion

Cite This Study

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