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Transillumination is used in dermatology in the examination of the breast, in the examination of the skull of infants, for superficial soft tissue tumors, and for large foreign bodies. In addition, transillumination can provide a technique of examination of the nails. This technique is possible without removal of the covering nail polish. This is appreciated by many woman patients. The nail lesions for which transillumination is especially effective include varying degrees of nail plate markings, onycholysis, subungual thickening, and leukonychia. Transillumination, then, helps in following the course of nail changes especially in psoriasis and in onychomycosis.
In a dark room, a single, narrow, strong beam of light is used underneath the flexor pad of the fingertip. The blackish lines of nail plate pits, separations of nail plate, and thicknesses are seen and differentiated readily from the diffuse homogenous reddish glow of the normal nail plate.
GOLDMAN L. Transillumination of Fingertip as Aid in Examination of Nail Changes. Arch Dermatol. 1962;85(5):644. doi:10.1001/archderm.1962.01590050074014
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