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 Author(s): Luc Thomas, Amélie Boespflug
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Author(s) Luc Thomas · Amélie Boespflug
Responsible author Luc Thomas→ send e-mail
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Status update June 25, 2018
Status by Ralph P. Braun




Drug-induced pigmentation

Many drugs can induce pigmentation of the nail plate, among them hydroxyurea, bleomycin and minocycline, with azidothymidine (AZT) being the most common. Dermoscopic features are very similar to those observed in lentiginoses with polydactylic gray longitudinal bands.

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Alopecia Areata

Alopecia areata is an autoimmune disorder characterized by transient, non-scarring hair loss and preservation of the hair follicle[1]. Alopecia areata can be associated to trachyonychia, where the nail plate shows multiple fine and superficial longitudinal fissures covered by thin scales[2]. . In the “shiny” variety of trachyonychia, the nail shows superficial ridging and a myriad of small geometrical pits.

Alopecia Arata -clinical.jpg Alopecia Areata -dermoscopy.jpg Alopecia Areata -dermoscopy 2.jpg



Lichen planus

Lichen planus can affect the nails and it is usually polydactyle. Nails are thinned and show longitudinal ridging and fissuring with distal splitting. Dermoscopy shows multiple deep longitudinal fissures reaching the distal part of the nail as well as partial absence of the nail plate[3]. A nail biopsy is mandatory to confirm the diagnosis. Dermoscopy can be useful to follow up and evaluate response to treatment.

Lichen planus.jpg Lichen planus dermoscopic.jpg



Psoriasis

Nail psoriasis is regularly associated with skin psoriasis. Pits, a punctated nail plate depressions covered by large scales and onycholysis with salmon borders is often visualised dermoscopically.

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Psoriasis -dermoscopy.jpg

  1. Alopecia areata C. Herbert Pratt, Lloyd E. King, Jr., Andrew G. Messenger, Angela M. Christiano, John P. Sundberg Nat Rev Dis Primers. Author manuscript; available in PMC 2017 Aug 28. Published in final edited form as: Nat Rev Dis Primers. 2017 Mar 16; 3: 17011. Published online 2017 Mar 16.
  2. Dermoscopy in the Evaluation of Nail Disorders Aurora Alessandrini, Michela Starace, Bianca Maria Piraccini Skin Appendage Disord. 2017 May; 3(2): 70–82. Published online 2017 Mar 8. doi: 10.1159/000458728
  3. Dermoscopy in the Evaluation of Nail Disorders Aurora Alessandrini, Michela Starace, Bianca Maria Piraccini Skin Appendage Disord. 2017 May; 3(2): 70–82. Published online 2017 Mar 8. doi: 10.1159/000458728
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