Background: Nail involvement is frequently observed in various dermatoses and can serve as an important clinical clue to underlying systemic or dermatological conditions. Dermoscopy (onychoscopy) enhances visualization of subtle nail changes that may not be evident on clinical examination alone.

Objectives:To evaluate dermoscopic features of nail lesions in different dermatoses and correlate them with clinical and demographic profiles.

Materials and Methods: A cross-sectional observational study was conducted on 53 patients presenting with nail changes associated with dermatoses. A detailed history, clinical examination, and dermoscopic evaluation were performed using a polarized handheld dermoscope. Findings were recorded and analyzed in terms of dermatoses type, nail changes, dermoscopic patterns, associated symptoms, and disease duration.

Results:The most common dermatoses were systemic lupus erythematosus (22.6%), alopecia areata (18.9%), eczema (15.1%), and psoriasis (13.2%). Nail pitting (24.5%) was the most frequent dermoscopic finding, followed by splinter hemorrhages (20.8%) and red lunula (18.9%). Brittle nails (34%) and thickening (32.1%) were the predominant gross nail changes. Notably, 60.4% of patients had dermatoses lasting more than 2 years, and 30.2% reported no associated nail symptoms.

Conclusion:Dermoscopy is a valuable non-invasive diagnostic tool for identifying nail involvement in various dermatoses, often detecting subclinical changes. Early dermoscopic evaluation can aid in prompt diagnosis and better management of underlying dermatological conditions.