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Abstract
Background: Onychomycosis is a common condition affecting 5.5% of the population worldwide and represents 20-40% of all onychopathies and about 30% of cutaneous mycotic infections. Nail dystrophies, often clinically indistinguishable from onychomycosis. A correct diagnosis of onychomycosis requires direct microscopic and cultural examinations, which are time-consuming and often impractical. Nowadays dermoscopy is frequently used for diagnosis of nail pathologies. Distinctive dermoscopic signs were found to be exclusive to distal subungual onychomycosis (DLSO). The proximal edge of the onycholytic area is jagged with indentations caused by sharp structures called {u2018}spikes{u2019} and the detached nail plate has an irregular matte pigmentation that is distributed in striae. Objectives: Our aim was to confirm these distinctive features that could facilitate the diagnosis of nail onychomycosis and that could differentiate it from other non onychomycotic nail changes and to determine the sensitivity and specificity of these dermoscopic features