Infection by human papillomavirus may lead to keratinocyte proliferation, that is responsible when located near the nail or peri-ungual and subungual warts. Nail dermoscopy can help diagnose subclinical subungual and peri-ungual warts that appear on the hyponychium, the proximal nail fold and can extend to the nail bed.
Clinically they appear as red scally papules. Dermoscopy shows a punctate rough surface and dilated capillaries of the papillary dermis, on a yellow structureless background with red or black dots with short lines that correspond to past hemorrhages and vessels that are important to differentiate these lesions with corn, callus, or a clavus.
Trans-illumination can also help the diagnosis of patients with a subungual wart.
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