# Intra‐Operative Onychoscopy of Subungual Epidermoid Inclusions

## TL;DR

This paper describes a case of subungual epidermoid inclusions and shows how intra-operative onychoscopy can help detect them during nail biopsies.

## Contribution

The study introduces intra-operative onychoscopy as a useful technique for identifying subungual epidermoid inclusions during nail procedures.

## Key findings

- Intra-operative onychoscopy helps detect subungual epidermoid inclusions during nail biopsies.
- Using this technique reduces the risk of inadequate biopsy samples for histopathology.

## Abstract

Subungual epidermoid inclusions (SEI) are small epithelial inclusions, sometimes solid but mostly with central keratinization of the onycholemmal type without a granular layer. Exceptionally, they become large enough to produce symptoms such as pain or swelling of the nail bed, resulting in subungual keratosis, onycholysis, or a dystrophic nail plate. Herein, we report a further case of SEI in a female patient with onychodystrophy of the great toe nail and highlight the onychoscopic features of SEI. Intra‐operative onychoscopy facilitates the detection of SEI during a nail bed biopsy and reduces the risk of obtaining inadequate specimens for histopathologic examination.