Nail dermoscopy findings in childhood psoriasis

Background and Design: Nail dermatoscopy or onychoscopy refers to the examination of the nail unit which consists of the proximal and lateral nail folds, hyponychium, nail plate and nail bed non-invasively. Nail biopsies which require surgical expertise are invasive procedures that are seldom performed by dermatologists in diagnosis of psoriasis. Nail dermatoscopy may offer a distinct advantage by helping avoid nail biopsies in diagnosis of childhood psoriasis. To evaluate the dermatoscopic features of nail psoriasis in a pediatric group of patients and to compare these findings with healty children. and Methods: A total of 45 pediatric patients with nail psoriasis (23 girls, 22 boys) and 45 healthy children were enrolled in the study group. Patients with active psoriatic skin lesions (confirmed by skin biopsy) who had at least one psoriatic nail feature were considered to have nail psoriasis. Psoriasis Area and Severity Index and Nail Psoriasis Severity Index scores are evaluated. Patients with onychomycosis were excluded. Dermatoscopic examination of all nails was performed using a manual dermatoscope with x10 magnification. χ2 test was used. : The most frequent dermatoscopic features in the nail bed and matrix were pitting (62.2%), punctate leukonychia (55.5%), haemorrhages (splinter and/or dot) (40%), distal onycholysis (40%), black filamentous structures (35.5%), trachyonychia (33.3%) and salmon patches (26.6%) while a reddish background with sparse dotted vessels (46.6%) and periungual desquamation (48.8%) were the most frequent findings in the proximal and lateral nail folds and in the adjacent skin, respectively. : This study highlights the usefulness of nail dermoscopy in helping the diagnosis of nail psoriasis by avoiding an additional nail biopsy in the pediatric population.