Current Practices of Subspecialty Nail Clinics: Results of a Survey of the Members of the Council for Nail Disorders.

Introduction: Knowledge of the structure and function of existing nail clinics remains limited. Sharing this knowledge from nail experts who run these clinics can readily support newly trained nail clinicians in setting up their nail clinics.

Method: We surveyed members of the Council for Nail Disorders (CND) to learn about the structure and practices of their nail clinics. Of the practicing CND members in any membership class, we analyzed responses from those who have nail clinics.

Results: Of the 79 practicing CND members, 38 responded (48.1% response rate), of whom 25 (65.8%) had a nail clinic. Analysis of these 25 responses revealed that 52% of nail clinics were relatively new (operating <5 years). The majority (72%) were in academic settings. Medical trainees were being taught in 64% of clinics. Nail clinics were directed by either one (64%) or multiple clinicians. All experts reported using clinical photographs in their routine care for nail patients, and 96% used dermoscopy. Additionally, 96% performed punch and tangential shave biopsies, and 88% performed matrixectomy. Access to a pathologist(s) with nail expertise was available in 84% of clinics.

Conclusion: Our findings characterize the current practices of nail clinics directed by CND members, serving as a guide for clinicians looking to establish their own.