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Peer-reviewedCC BY-NCClinical, cosmetic and investigational dermatology

Dermoscopic Spectrum of Nail Alterations in Pediatric Leprosy: A Cross-Sectional Study from an Endemic Settings.

  • Hendra Gunawan1,2
  • Sri Linuwih Menaldi2,3
  • Euis Nana Resna2,4
  • Melani Marissa2,3
  • Mufqi Handaru Priyanto2,5
  • Yuliana Teguh2,6
  • Inneke Viviane Sumolang2,7
  • Aqil Yuniawan Tasrif1,2
7 affiliations
  1. 1Department of Dermatology and Venereology, Faculty of Medicine, Universitas Padjadjaran - Dr. Hasan Sadikin General Hospital, Bandung, Indonesia.
  2. 2The Indonesian Leprosy Study Group - The Indonesian Society of Dermatology and Venereology, Jakarta, Indonesia.
  3. 3Department of Dermatology and Venereology, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia.
  4. 4Department of Dermatology and Venereology, Cibinong Regional General Hospital, Bogor, Indonesia.
  5. 5Department of Dermatology and Venereology, Faculty of Medicine, Universitas Indonesia - Universitas Indonesia Hospital, Depok, Indonesia.
  6. 6Department of Dermatology and Venereology, Mitra Medika Hospital, Pontianak, Indonesia.
  7. 7Department of Dermatology and Venereology, Faculty of Medicine, Universitas Cendrawasih, Jayapura, Indonesia.
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Abstract

Background

Nail involvement in leprosy has been reported, but data in pediatric patients remain limited. Dermoscopy may detect subtle nail abnormalities not evident on routine examination.Purpose

This study evaluated dermoscopic nail alterations in pediatric leprosy patients in an endemic setting.Patients and methods

A descriptive cross-sectional study was conducted among pediatric patients with confirmed leprosy in Papua, Indonesia. All patients younger than 15 years with a clinical and bacteriological diagnosis of leprosy were included. Nail examinations were performed on fingernails and toenails using a handheld dermoscope with 10× magnification. Direct microscopic examination with 10% potassium hydroxide was performed to exclude onychomycosis. The types and distribution of nail alterations were recorded and analyzed descriptively. Dermoscopic images were captured using a 1200D digital single-lens reflex camera attached to the dermoscope in polarized mode without linkage fluid.Results

A total of 24 pediatric patients with leprosy were included in the study. Among the 18 patients with available leprosy classification, 17 (94.4%) were classified as multibacillary (MB) and 1 (5.6%) as paucibacillary (PB); classification was unknown for 6 patients (25.0%). Nail abnormalities involved both fingernails and toenails (62.5%). Leukonychia was the most frequent nail finding, observed in eight patients (33.3%), followed by transverse nail lines in four patients (16.7%). Other findings included onychorrhexis, longitudinal ridging, onychogryphosis, subungual hyperkeratosis, onycholysis, and longitudinal melanonychia. Several patients also presented with combined nail abnormalities.Conclusion

Nail alterations are observed in a substantial proportion of pediatric leprosy patients in this study, particularly leukonychia and transverse nail lines. Dermoscopy helps detect subtle abnormalities that may be missed on routine examination, supporting clinical assessment in pediatric leprosy.

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Cite

BibTeXRIS
BibTeX
@article{gunawan2026dermoscopic,
  title = {{Dermoscopic Spectrum of Nail Alterations in Pediatric Leprosy: A Cross-Sectional Study from an Endemic Settings.}},
  author = {Hendra Gunawan and Sri Linuwih Menaldi and Euis Nana Resna and Melani Marissa and Mufqi Handaru Priyanto and Yuliana Teguh and Inneke Viviane Sumolang and Aqil Yuniawan Tasrif},
  journal = {Clinical, cosmetic and investigational dermatology},
  year = {2026},
  month = oct,
  doi = {10.2147/ccid.s644564},
  url = {https://europepmc.org/article/MED/42948674},
  note = {CC BY-NC},
}
RIS
TY  - JOUR
TI  - Dermoscopic Spectrum of Nail Alterations in Pediatric Leprosy: A Cross-Sectional Study from an Endemic Settings.
AU  - Hendra Gunawan
AU  - Sri Linuwih Menaldi
AU  - Euis Nana Resna
AU  - Melani Marissa
AU  - Mufqi Handaru Priyanto
AU  - Yuliana Teguh
AU  - Inneke Viviane Sumolang
AU  - Aqil Yuniawan Tasrif
PY  - 2026
DA  - 2026/10/23
JO  - Clinical, cosmetic and investigational dermatology
DO  - 10.2147/ccid.s644564
UR  - https://europepmc.org/article/MED/42948674
AB  - Background  Nail involvement in leprosy has been reported, but data in pediatric patients remain limited. Dermoscopy may detect subtle nail abnormalities not evident on routine examination.Purpose  This study evaluated dermoscopic nail alterations in pediatric leprosy patients in an endemic setting.Patients and methods  A descriptive cross-sectional study was conducted among pediatric patients with confirmed leprosy in Papua, Indonesia. All patients younger than 15 years with a clinical and bacteriological diagnosis of leprosy were included. Nail examinations were performed on fingernails and toenails using a handheld dermoscope with 10× magnification. Direct microscopic examination with 10% potassium hydroxide was performed to exclude onychomycosis. The types and distribution of nail alterations were recorded and analyzed descriptively. Dermoscopic images were captured using a 1200D digital single-lens reflex camera attached to the dermoscope in polarized mode without linkage fluid.Results  A total of 24 pediatric patients with leprosy were included in the study. Among the 18 patients with available leprosy classification, 17 (94.4%) were classified as multibacillary (MB) and 1 (5.6%) as paucibacillary (PB); classification was unknown for 6 patients (25.0%). Nail abnormalities involved both fingernails and toenails (62.5%). Leukonychia was the most frequent nail finding, observed in eight patients (33.3%), followed by transverse nail lines in four patients (16.7%). Other findings included onychorrhexis, longitudinal ridging, onychogryphosis, subungual hyperkeratosis, onycholysis, and longitudinal melanonychia. Several patients also presented with combined nail abnormalities.Conclusion  Nail alterations are observed in a substantial proportion of pediatric leprosy patients in this study, particularly leukonychia and transverse nail lines. Dermoscopy helps detect subtle abnormalities that may be missed on routine examination, supporting clinical assessment in pediatric leprosy.
SN  - 1178-7015
ER  -