Nail Lacquer: A Common Artifact That May Go Unrecognized

Alexandra E Reis, BA, Ajay N Amarnani, MD, Christopher A D’Angelis, MD, PhD, Thomas N Helm, MD


Nail specimens are being submitted with increased frequency to confirm a diagnosis of onychomycosis, diagnose an inflammatory dermatosis, or identify clues to an underlying neoplasm. Samples often are associated with a variety of lacquers (aka polish, varnish, enamel) or gels that may vary in their appearance. Some lacquers or gel polishes add challenges to maintaining an even plane of sectioning, obscure underlying findings, or separate from the nail in processing and be misinterpreted as terra firma. We review the histologic appearance of common lacquers and gel polishes so that dermatopathologists recognize these different presentations in clinical practice.

[N A J Med Sci. 2017;10(2):65-69.   DOI:  10.7156/najms.2017.1002065]


nail polish, nail cosmetics, lacquer, histologic artifact, nail plate, nail unit, onychomycosis

Full Text:



Reich A, Szepietowski JC. Health-related quality of life in patients with nail disorders. Am J Clin Dermatol. 2011;12:313-320.

Jefferson J, Rich P. Update on nail cosmetics. Dermatol Ther. 2012;25:481-490.

Global Premium Nail Polish Market 2015-2019 - Forecasts the Global Premium Nail Polish Market to Grow at a CAGR of 6.23% Over the Period 2014-2019. Business Wire. 2016. Accessed August 8th, 2016.

Brookman, F. Aiming for New Lengths: Nail Trends Heat Up in 2013. WWD. 2013. Accessed August 8th, 2016.

Nails 2015 Big Book Statistics. Nails Magazine. 2016. Accessed August 8th, 2016.

Schlossman ML, Wimmer EP. The history of nail polish. Cosmet Toiletries. 1992; 9:115.

Meisel M. Style at their fingertips: a look at 50 years of nail polish innovations. Household & Personal Products Industry. 2013;50:46-49.

Barnes J. Show of hands: innovations in gel polishes up the ante for spa manicures, preserving nails and improving your spa's loyal client base. American Spa. 2014;7:62-63.

Sun C, Koppel K, Adhikari K. Sensory factors affecting female consumers' acceptability of nail polish. Int J Cosmetic Sci. 2015;37:642-650.

Chen AF, Chimento SM, Hu S, Sanchez M, Zaiac M, Tosti A. Nail damage from gel polish manicure. J Cosmet Dermatol. 2012;11:27-29.

Dahlin J, Berne B, Dunér K, et al. Several cases of undesirable effects caused by methacrylate ultraviolet-curing nail polish for non-professional use. Contact Dermatitis. 2016;75:151-156.

Madnani N, Khan K. Nail cosmetics. Indian J Dermatol VE. 2012;78:309.

Wilsmann-Theis D, Sareika F, Bieber T, Schmid-Wendtner MH, Wenzel J. New reasons for histopathological nail-clipping examination in the diagnosis of onychomycosis: PAS-staining in the diagnosis of onychomycosis. J Eur ACAD Dermatol. 2011;25:235-237.

Stephen S, Tosti A, Rubin AI. Diagnostic applications of nail clippings. Dermatol Clin. 2015;33:289-301.

Anolik RB, Elenitsas R, Minakawa S, Nguyen J, Rubin AI. Histologic features of nail cosmetics. Am J Dermatopath. 2012;34:412-415.

Zimmer KA, Clay T, Vidal CI et al. Microscopy of Common Nail Cosmetics. Am J Dermatopath. 2017;1:1-5.

Fernandez-Flores A. Morphology of rare exogenous materials in dermatopathology. J Cutan Pathol. 2017:44:237-248.

Reis A, Amarnani A, D'Angelis C, Helm T. Nail lacquer: a common artifact that may go unrecognized. Poster presented at the American Society of Dermatopathology 53rd Annual Meeting; 2016, October 27 - 30; Chicago, IL.


  • There are currently no refbacks.