الفهرس 
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Abstract
Nail dermoscopy (onychoscopy) is a valuable diagnostic tool for evaluating diseases in the nail apparatus. It is non-invasive procedure, allowing clinicians to prioritize particular nails for biopsy. Thus, it can improve diagnostic accuracy and expedite treatment. Nail dermoscopy has initially been used for the assessment of nail pigmentation, but its utilization has expanded for the diagnosis of all nail disorders; it became a routine diagnostic instrument, as its reveals helpful information. Dermoscopy can be applied to all visible parts of the nail unit, and even the nail matrix can be studied. With dermoscopy (onychoscopy), many nail signs can be magnified and combined with clinical examination to reach a diagnosis. The nail is visible as a whole only at ×10 magnification, but observation can be improved with magnifications ranging from ×20 to ×70, moving the lens back and forth and transversally. The particular anatomy of the nail apparatus makes dermoscopy not easy to perform and difficult to be interpreted. In most of the cases, dermoscopy only enhances signs already visible with the naked eye, acting only as an illuminated magnifying lens, but the features it shows are anyway very fascinating and unique. We aimed to evaluate the role of onychoscopy in diagnosis of nonneoplastic nail diseases in adults to determine the dermoscopic features of different nail disorders. This study was carried out on 60 patients with different types of nonneoplastic nail disorders in Tanta University Hospitals in Out-patient Clinics of Dermatology and Venereology Department. They were evaluated according to clinical, dermoscopic and mycological examination. • The results of this study revealed the following: The age of the studied patients ranged from 20 to 70 years, females were more predominant than males and the majority of them were house wives mostly from rural areas. Dermoscopic examination of the studied patients with onychomycosis (31.66% patients) revealed that onycholysis with jagged proximal edge (89.47%) and chromonychia (89.47%) were the most frequently observed features that were observed. Psoriasis with nail involvement were observed in (30%) of patients. The most common dermoscopic nail matrix change that was found was pitting in 13 (72.22%) patients, followed by onycholysis with erythematous border in 66.67% and splinter hemorrhage and subungual hyperkeratosis in 55.56% of patients. Five percent patients were diagnosed to have lichen planus. The most common observed dermoscopic findings among them were longitudinal striation, crumbling and splinter haemorrhages as they were detected in 2 (66.67%) patients. Traumatic nail disorder had been observed in (6.67%). The main dermoscopic findings were subungual haemorraghes and onycholysis. In the onycholytic area, the line of the detachment of the plate from the bed was linear, regular and smooth. Subungual haemorraghes were characterized by round shape and homogenous pigmentation without longitudinal lines. The study reported (5%) of patients with Darier‘s disease. longitudinal ridging, splinter haemorrhages and longitudinal leukonychia were the most frequently observed features that were reported in (100%) patients. • Absent lunula was found in (66.67%) patients. Irregular free edge and hair pin blood vessels were found in (33.33%) patient. Immune-bullous skin diseases were reported in (6.67%) patients within the study. The dorsolateral onycholysis and subungual hyperkeratosis were observed in the (75%) patients followed by subungual haemorraghe and chromonychia that were reported in (50%) patients. Also, onychorrhexis was observed as nail matrix changes in (50%) patients. There were (5%) patients with nail warts. The most common findings were red coloured dots that were reported in all cases, followed by hyperkeratotic surface that was observed in (66.67%) of patients. There were (3.33%) patients with collagen disorders had nail affection. Only one patient had localized scleroderma, the nail showed subungual haemorrhage. Periungular telangectasia could be dermoscopically observed on the other patient that had systemic sclerosis. Eczema was observed in (3.3%) patients. By onychoscopy, beau‘s line, peri-ungual scales, longitudinal deep lines and lusterless surface were observed. One patient with alopecia areata was included in our study. Pitting was easily visualized by dermoscope and characterized by small, shallow, and regularly arranged pitting that was easy to be distinguished from pitting of psoriasis that was deep and irregularly arranged. Onychoscopy of leukonychia showed white dots in the plate, with a normally smooth and transparent nail plate surface.