Artificial Intelligence in Diagnosis and Management of Nail Disorders: A Narrative Review

Abstract Background: Artificial intelligence (AI) is revolutionizing healthcare by enabling systems to perform tasks traditionally requiring human intelligence. In healthcare, AI encompasses various subfields, including machine learning, deep learning, natural language processing, and expert systems. In the specific domain of onychology, AI presents a promising avenue for diagnosing nail disorders, analyzing intricate patterns, and improving diagnostic accuracy. This review provides a comprehensive overview of the current applications of AI in onychology, focusing on its role in diagnosing onychomycosis, subungual melanoma, nail psoriasis, nail fold capillaroscopy, and nail involvement in systemic diseases. Materials and Methods: A literature review on AI in nail disorders was conducted via PubMed and Google Scholar, yielding relevant studies. AI algorithms, particularly deep convolutional neural networks (CNNs), have demonstrated high sensitivity and specificity in interpreting nail images, aiding differential diagnosis as well as enhancing the efficiency of diagnostic processes in a busy clinical setting. In studies evaluating onychomycosis, AI has shown the ability to distinguish between normal nails, fungal infections, and other differentials, including nail psoriasis, with a high accuracy. AI systems have proven effective in identifying subungual melanoma. For nail psoriasis, AI has been used to automate the scoring of disease severity, reducing the time and effort required. AI applications in nail fold capillaroscopy have aided the analysis of diagnosis and prognosis of connective tissue diseases. AI applications have also been extended to recognize nail manifestations of systemic diseases, by analyzing changes in nail morphology and coloration. AI also facilitates the management of nail disorders by offering tools for personalized treatment planning, remote care, treatment monitoring, and patient education. Conclusion: Despite these advancements, challenges such as data scarcity, image heterogeneity, interpretability issues, regulatory compliance, and poor workflow integration hinder the seamless adoption of AI in onychology practice. Ongoing research and collaboration between AI developers and nail experts is crucial to realize the full potential of AI in improving patient outcomes in onychology.