Onychoscopy is a simple, office-based, non-invasive procedure, which is a second link between naked eye examination and nail biopsy. As such, there are no standard techniques described for onychoscopy. The examination of the distal nail plate and distal nail fold is difficult because of convexity and a distal free end. As a result of which, it becomes difficult to hold the dermoscope in a stable position at the distal end of the nail plate, causing distortion of views and the images clicked.

To overcome this problem, we suggest using a foam piece as a cushion for placing the dermoscope at the distal end of the nail plate. A simple packing foam piece of any colour of desired thickness is taken and the impression of fingers of one or both hands, with or without the thumb is marked on the foam with a pen and cut accordingly. The single-hand template can be used for the opposite hand by using the reverse side of the template. The fingers fit well in the window created and the dermoscope can then be held in a stable position at the distal end because of a stable platform provided by the foam piece [Figure 1, Video 1]. Few standard templates of adult males, females and children of broad age groups can be customised and used for most patients. To make it attractive for children for better compliance, some sticker art can be pasted on the foam piece [Figure 2]. A cling film can be wrapped over the template to minimise cross-infection. This simple, economical, easy to create framework can bring a change in the technique of onychoscopy and improve the quality of images [Video 1].

Figure 1:: Onychoscopy of an adult case using a foam piece as a cushion at the distal end

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Figure 2:: Onychoscopy of a paediatric case using coloured foam piece with sticker art as cushion

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