A comparative study of onychomycosis and traumatic toenail onychodystrophy dermoscopic patterns.


Journal

Journal of the European Academy of Dermatology and Venereology : JEADV
ISSN: 1468-3083
Titre abrégé: J Eur Acad Dermatol Venereol
Pays: England
ID NLM: 9216037

Informations de publication

Date de publication:
Apr 2019
Historique:
received: 23 07 2018
accepted: 17 10 2018
pubmed: 24 11 2018
medline: 6 8 2019
entrez: 24 11 2018
Statut: ppublish

Résumé

Onychomycosis (OM) and traumatic onychodystrophy (OD) are common causes of toenail changes. A clinical diagnosis is often impossible without mycology. Dermoscopy is helpful in this setting but yet underexplored. Prospective comparative studies between OM and OD onychoscopic findings have not been previously performed. We sought to determine distinguishing dermoscopic presentations of OM and traumatic OD. We performed a prospective, observational study including patients presenting with ≥1 toenail onychodystrophy. All underwent onychoscopy, clinical and mycological examination. Based on these results, patients received a final diagnosis of OM or OD. Dermoscopic presentations of OM and OD patients were classified in patterns and compared. In all, 110 cases of OM and 82 of traumatic OD were compared. Statistical analyses revealed that the distal pulverized and the irregular spiked macular dermoscopic patterns were predictors of an OM diagnosis. The regular macular, the non-classifiable, the total and partial homogeneous background dermoscopic patterns correlated with traumatic OD diagnosis. We demonstrated that OM and traumatic OD have distinctive onychoscopic presentations. Dermoscopy may be an important ancillary tool to guide their differential.

Sections du résumé

BACKGROUND BACKGROUND
Onychomycosis (OM) and traumatic onychodystrophy (OD) are common causes of toenail changes. A clinical diagnosis is often impossible without mycology. Dermoscopy is helpful in this setting but yet underexplored. Prospective comparative studies between OM and OD onychoscopic findings have not been previously performed.
OBJECTIVES OBJECTIVE
We sought to determine distinguishing dermoscopic presentations of OM and traumatic OD.
METHODS METHODS
We performed a prospective, observational study including patients presenting with ≥1 toenail onychodystrophy. All underwent onychoscopy, clinical and mycological examination. Based on these results, patients received a final diagnosis of OM or OD. Dermoscopic presentations of OM and OD patients were classified in patterns and compared.
RESULTS RESULTS
In all, 110 cases of OM and 82 of traumatic OD were compared. Statistical analyses revealed that the distal pulverized and the irregular spiked macular dermoscopic patterns were predictors of an OM diagnosis. The regular macular, the non-classifiable, the total and partial homogeneous background dermoscopic patterns correlated with traumatic OD diagnosis.
CONCLUSIONS CONCLUSIONS
We demonstrated that OM and traumatic OD have distinctive onychoscopic presentations. Dermoscopy may be an important ancillary tool to guide their differential.

Identifiants

pubmed: 30468535
doi: 10.1111/jdv.15358
doi:

Types de publication

Comparative Study Journal Article Observational Study

Langues

eng

Pagination

786-792

Informations de copyright

© 2018 European Academy of Dermatology and Venereology.

Auteurs

R Ramos Pinheiro (R)

Department of Dermatology, Centro Hospitalar Universitário de Lisboa Central, Lisbon, Portugal.

T Dias Domingues (T)

Center of Statistics and Applications, CEAUL, Lisbon University, Lisbon, Portugal.

V Sousa (V)

Department of Dermatology, Centro Hospitalar Universitário de Lisboa Central, Lisbon, Portugal.

C Galhardas (C)

Mycology Department, Centro Hospitalar Universitário de Lisboa Central, Lisbon, Portugal.

M Apetato (M)

Department of Dermatology, Centro Hospitalar Universitário de Lisboa Central, Lisbon, Portugal.
Mycology Department, Centro Hospitalar Universitário de Lisboa Central, Lisbon, Portugal.

A Lencastre (A)

Department of Dermatology, Centro Hospitalar Universitário de Lisboa Central, Lisbon, Portugal.
Mycology Department, Centro Hospitalar Universitário de Lisboa Central, Lisbon, Portugal.

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