Onychoscopic evaluation of distal and lateral subungual onychomycosis: A cross-sectional study in Lebanon

Authors

1 Clemenceau medical center

2 Saint George Hospital University Medical Center, Beirut- Faculty of Medicine, University of Balamand

3 Clinic of Dermatology, Ouled Fayet

Abstract

Background and Purpose: The aim of this study was to evaluate the onychoscopic patterns associated with distal lateral subungual onychomycosis (DLSO) in Lebanon.
Materials and Methods: The present study was conducted on 45 patients with clinical DLSO attending two dermatology clinics in Beirut, Lebanon, between January 2018 and April 2018. The patients were subjected to dermoscopy to identify the onychoscopic patterns.

Results: The DLSO was predominantly associated with white, yellow, and brown color changes (p <0.05). Dermoscopic patterns of longitudinal striae (n=31; 68.75%), spiked pattern (n=25; 55.5%), and jagged pattern (n=25; 55.5%) were significantly correlated with DLSO (p <0.001). Our findings are in accordance with five previous reports in which dermoscopic findings are discussed in onychomycosis.

Conclusion: It is recommended to perform further studies on homogeneous groups with different clinical subtypes of onychomycosis including patients with suspected traumatic onycholysis or other nail diseases. Identification of onychoscopic patterns would offer the clinicians a quick, simple, and complementary tool for the diagnosis of onychomycosis.

Keywords


1. Murray SC, Dawber RP. Onychomycosis of toenails: orthopedic and pediatric considerations. Australas J Dermatol. 2002; 43(2):105-12.
2. Midgley G, Moore MK. Nail infections. Dermatol Clin. 1996; 14(1):41-9.
3. Richard K, Scher PK. Onychomycosis: a significant medical disorder. J Am Acad Dermatol. 1996; 35(3):S2-5.
4. El Sayed F, Ammoury A, Haybe RF, Dhaybi R. Onychomycosis in Lebanon: a mycological survey of 772 patients. Mycoses. 2006; 49(3):216-9.
5. Baran R, Hay R, Haneke E, Piraccini BM, Tosti A. Onychomycosis: the current approach to diagnosis and therapy. Florida: CRC Press; 2006.
6. Kaur R, Kashyap B, Bhalla P. Onychomycosis--epidemiology, diagnosis and management. Indian J Med Microbiol. 2008; 26(2):108-16.
7. Chang A, Wharton J, Tam S, Kovich OI, Kamino H. A modified approach to the histologic diagnosis of onychomycosis. J Am Acad Dermatol. 2007; 57(5):849-53.
8. Piraccini BM, Balestri R, Starace M, Rech G. Nail digital dermoscopy (onychoscopy) in the diagnosis of onychomycosis. J Eur Acad Dermatol Venereol. 2013; 27(4):509-13.
9. Jesus-Silva MA, Fernandez-Martınez R, Roldan-Marin R, Arenas R. Dermoscopic patterns in patients with a clinical diagnosis of onychomycosis-results of a prospective study including data of potassium hydroxide (KOH) and culture examination. Dermatol Pract Concept. 2015; 5(2):39-44.
10. De Crignis G, Valgas N, Rezende P, Leverone A, Nakamura R. Dermatoscopy of onychomycosis. Int J Dermatol. 2014; 53(2):e97-9.
11. Yadav TA, Khopkar US. White streaks: dermoscopic sign of distal lateral subungual onychomycosis. Indian J Dermatol. 2016; 61(1):123.
12. Chetana K, Menon R, David BG. Onychoscopic evaluation of onychomycosis in a tertiary care teaching hospital: a cross-sectional study from South India. Int J Dermatol. 2018; 57(7):837-42.