Abstract:

Objective To make a definite diagnosis of acquired nonfungal onychopathy of unclear origin via histopathological examination on nail units, and to assess the relationship between onychopathy and type of nail damage. Methods A total of 52 patients with onychopathy but without cutaneous or mucosal manifestations were included in this study. Mycological examination of involved nails was negative in all patients. Histopathological examination was performed on nail units following longitudinal nail biopsy. Results Fourteen cases were diagnosed as nail psorsiasis （NP）, which was commonly manifested as pitted nail, onychorrhexis and thick nail. Nail lichen planus （NLP） was diagnosed in 21 patients, who presented with two categories of nail damage; one category included onychatrophy, pterygium unguis and anonychia, the other one included nail distal splitting, nail longitudinal ridging and thin nail. Seventeen cases showed non-specific eczematous changes, and the most common manifestations were sandpaper nail and nail longitudinal ridging. Conclusions There is some correlation between some types of nail damage and patterns of nail unit pathology. To understand this correlation will provide important evidence on clinical diagnosis and differential diagnosis of acquired nonfungal onychopathy.

Key words: Nail biopsy, Nail histopathology, Nail psoriasis, Nail lichen planus, Nail non-specific inflammation