The Analysis Of Dermoscopic Features Of Onychomycosis And Nail Psoriasis

Objective: Explore the Dermoscopic features of onychomycosis and nail psoriasis,aim to offer help for the clinical diagnosis of onychomycosis and nail psoriasis,also provides a reference for the differential diagnosis of various nail diseases.Methods:Respectively select 128 patients with onychomycosis and 128 patients with nail psoriasis who came to see a doctor in Qingdao Municipal Hospital from2016.4 to 2017.4.All rhe patients have received mycology examination of their own accord.The patients with onychomycosis are required for a positive result of mycology examination which means hyphae can be observed clearly and the patients with nail psoriasis are reqired a negative result more than three times.The patients who are with injured nails or other diseases that can cause nail change should be excluded.Investigate all the patients and record the basic information,collect the pictures with dermatoscope at the same time.Classify and analyze the pictures,explore the dermoscopic features of onychomycosis and nail psoriasis.Results:In our study,the 128 patients with onychomycosis are divided into fourclinical subtypes,they are 29/128 of superficial white onychomycosis(SWO),53/128 of distal lateral subungual onychomycosis(DLSO),19/128 of proximal onychomycosis(PSO)and 27/128 of total dystrophic onychomycosis(TDO),respectively.All the patients with onychomycosis have 7 kinds of dermoscopic features,they are 69/128 of jagged edge,72/128 of longitudinal striae,30/128 of hyperkeratosis as cones,21/128 of nail plate thickening,5/128 of black dot,26/128 of oncholysis,23/128 of nail discoloration,respectively.In our study,jagged edge show a higher proportion in DLSO than other clinical subtypes of onychomycosis,the distributional difference is significant(p<0.01).Longitudinal striae also show a higher proportion in DLSO than other clinical subtypes,the distributional difference is significant(p<0.01).Hyperkeratosis as cones show a higher proportion in TDO than other clinical subtypes,the distributional difference is significant(p<0.01).Nail plate thickening,black dot,oncholysis and nail discoloration show different proportion in the four clinical subtypes,but the distributional difference is insignificant(p>0.05).In our study,the 128 patients with nail psoriasis are divided into four clinical subtypes,they are 54/128 of psoriasis vulgaris,19/128 of erythroderma psoriaticum,24/128 of psoriasis pustulosa and 31/128 of psoriasis arthropathica,respectively.All the patients with nail psoriasis also have 7kinds of dermoscopic features,they are 61/128 of pitting,41/128 of blot sign,41/128 of splinter haemorrhage,23/128 of dilated hyponychial capillaries,20/128 of nail plate thickening,20/128 of oncholysis,13/128 of nail discoloration,respectively.In our study,blot sign show a higher proportion in psoriasis vulgaris and psoriasis arthropathica than other clinical subtypes of psoriasis,the distributional difference is significant(p<0.05).Dilated hyponychial capillaries show a higher proportion in psoriasis pustulosa than other clinical subtypes of psoriasis,the distributional difference is significant(p<0.05).Pitting,splinter haemorrhage,nail plate thickening,oncholysis and nail discoloration show different proportion in the four clinical subtypes,but the distributional difference is insignificant(p>0.05).Conclusion: 1.The dermoscopic features of onychomycosis with relative specificity include jagged edge,longitudinal striae,hyperkeratosis as cones and black dot.The dermoscopic features of nail psoriasis with relative specificity include pitting,blot sign,splinter haemorrhage and dilated hyponychial capillaries.The common dermoscopic features include nail plate thickening,oncholysis and nail discoloration.2.The proportion of jagged edge and longitudinal striae are higher in DLSO,the proportion of hyperkeratosis as cones is higher in TDO,the distributional difference is significant.3.The proportion of blot sign is higher in psoriasis vulgaris and psoriasis arthropathica,The proportion of dilated hyponychial capillaries is higher in psoriasis pustulosa,the distributional difference is significant.