Abstract:
Aim: Distal subungual onychomycosis is a common public health problem which composes a large part of nail diseases. The exact
diagnosis of the disease is often unfeasible without mycological investigations.
In this study, we aimed to reveal sensitivity and specificity of previously described onychoscopic (nail dermoscopic) features that
support and facilitate diagnosis of distal subungual onychomycosis.
Material and Methods: Big toe nail of 53 patients who present with distal onycholysis were examined by digital dermatoscopy and
were photographed. Specific dermatoscopic features were recorded. Mycological investigations were performed in all patients and
dermatoscopic diagnosis was compared with mycological diagnosis. Three patients were excluded from the study whose final
diagnoses were psoriasis.
Results: Two specific findings previously described as longitudinal stria and spike were obtained as a result of examination of the
dermatoscopic imaging. Sensitivity and specificity of longitu-dinal stria sign was found as 75.7% and 88.2% respectively. Sensitivity
and specificity of spike sign was found as 57.5% and 94.1% respectively. And finally sensitivity and specificity of the presence of at
least one of the two signs was found as 96,9% and 88,2%, respectively.
Conclusion: Dermoscopic examination is very useful and cost-effective method in diagnosis of the distal subungual onychomycosis
