The Features Of Onychomycosis And Nail Psoriasis Under The Dermoscopic

Objective: Observing the dermoscopic images of onychomycosis and nail psoriasis,analyze the dermoscopic features of two diseases,which use to help diagnosis and differential diagnosis.Methods: We collected clinical data of onychomycosis without antifungal therapy and nail psoriasis in the Affiliated Hospital of North Sichuan Medical College from 2016.10 to 2017.10.Clinical images of each nail were taken by digital camera.And dermoscopic images of each nail were shot with digital dermoscopic system.Samples were obtained for light microscopy and culture.The frequency of each pattern were analyzed statistically with chi-square test.Results:1.In 67 cases of onychomycosis,male were 33,female were 34,male to female ratio was 1:1.03.The age of patients range from 2 to 84 years old.The average onset age was 39.9 years old.The dermoscopy features of onychomycosis:nail bed longitudinal ridges/ ruin appearance47/67(70.1%),longitudinal striae 40/67(59.7%),onycholysis 22/67(32.8%),splinter hemorrhages 34/67(50.7%),colour changes 67/67(100%),jagged adge 18/67(26.9%),matte nail 67/67(100%),thick nail 67/67(100%).2.In 50 casesof nail psoriasis,male were 34,female were 16,male to female ratio was 2.125:1.The age of patients range from 4 to 72 years old.The average onset age was 45.1 years old.The dermoscopy features of nail psoriasis: pitting 47/50(94%),onycholysis 6/50(12%),salmon patch16/50(32%),splinter hemorrhages 22/50(44%),subungual keratosis 13/50(26%),nail distruction(horizontal streak/rough/thick/longitudinal crack)21/50(42%),microvascular changes21/50(42%),pseudo-fiber sign 7/50(14%).3.In 6 cases of nail psoriasis with onychomycosis,male were 4,female were 2,male to female ratio was 4:2.The age of patients range from 27 to 76 years old.The average onset age was 51.3 years old.The dermoscopy features of onychomycosis: nail bed longitudinal ridges/ ruin appearance 3/6(50%),longitudinal striae 5/6(83.3%),onycholysis 2/6(33.3%),splinter hemorrhages 4/6(66.67%),nail distruction 6/6(100%).Conclusion: 1.Characteristic dermoscopy features of onychomycosis: nail bed longitudinal ridges,longitudinal striae,ruin appearance,jagged adge.2.Characteristic dermoscopy features of nail psoriasis: pitting,salmon patch,microvascular changes.3.Nail distructioninonychomycosiswas more frequently than in nail psoriasis.4.The demoscopy features of onychomycosis and nail psoriasis contribute to the diagnosis and diffrerential diagnosis of two diseases.The dermoscopyfeatures can provide a certain amount of diagnostic evidence,especially for the patients with atypical skin lesions.