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van de Borne L, Costantini M, Dehavay F, Richert B. Onychomatricomas: A 41-Case Series to Assess Surgical Outcome. Dermatol Surg 2024:00042728-990000000-00859. [PMID: 38924505 DOI: 10.1097/dss.0000000000004306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/28/2024]
Abstract
BACKGROUND Onychomatricoma (OM) is a rare benign tumor of the nail matrix. Treatment is surgical, but data are currently limited. OBJECTIVE To review all cases of OM operated in their department and to assess the link between the location on the nail plate, the thickness and width of the lesion, and the postoperative outcomes. MATERIALS AND METHODS Records of 62 patients were retrieved from their department's database over a 25-year period (1998-2023). RESULTS Of the 62 patients, 41 were eligible. In total, 58% of OM occupied a width of a quarter of the nail plate, 51% had a plate thinner than 3 mm, and 51% were laterally located. Of the 41 patients included, 29 had a tangential excision and 12 underwent lateral longitudinal excision. Among the tangential excision group, 71% had normal nail regrowth. Onychomatricoma thicker than 3 mm and involving the total nail plate width had a sequelae in 60% of cases. CONCLUSION Tangential excision of onychomatricomas allows a normal nail regrowth in 71% of cases. The risk of sequelae increases for tumors thicker than 3 mm and involving the total nail plate width. Medial or lateral location seems to have no influence.
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Affiliation(s)
- Laura van de Borne
- Department of Dermatology, Saint-Pierre and Brugmann University Hospitals, Université Libre de Bruxelles, Brussels, Belgium
| | - Mathilde Costantini
- Department of General Medicine, Université Libre de Bruxelles, Brussels, Belgium
| | - Florence Dehavay
- Department of Dermatology, Saint-Pierre and Brugmann University Hospitals, Université Libre de Bruxelles, Brussels, Belgium
| | - Bertrand Richert
- Department of Dermatology, Saint-Pierre and Brugmann University Hospitals, Université Libre de Bruxelles, Brussels, Belgium
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Samson P, Curvale C, Iniesta A, Gay A. Managing longitudinal melanonychia. HAND SURGERY & REHABILITATION 2024; 43S:101526. [PMID: 38879227 DOI: 10.1016/j.hansur.2022.12.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Accepted: 12/29/2022] [Indexed: 06/25/2024]
Abstract
Longitudinal melanonychia (LM) is a pigmented band extending from the matrix to the distal edge of a nail. It is caused by increased production of melanin within the matrix, and integration into the nail plate. The origin of this production is usually benign, due to activation, hyperplasia or proliferation of melanocytes normally present in the matrix. In some cases, however, LM is the manifestation of a subungual melanoma, the diagnosis of which must be made early. Biographical, clinical and dermoscopic criteria make it possible to suspect melanoma and decide whether to perform biopsy. None of these criteria, however, are specific and definitive diagnosis requires pathologic examination of a matrix biopsy. The biopsy technique should enable reliable histological study while limiting the risk of secondary nail dystrophy. Initial resection should ideally involve the entire lesion. Complete elevation of the nail plate enables the lesion to be precisely located. Lesions up to 3 mm can be removed by longitudinal resection biopsies without significant sequelae. In more extensive lesions, incision or tangential ("shave") biopsy can be performed without impairing prognosis. In clinical presentations strongly suggestive of melanoma, immediate complete resection of the entire nail unit may be proposed.
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Affiliation(s)
- P Samson
- Institut de la Main et du Membre Supérieur, Marseille, France.
| | - C Curvale
- Institut de la Main et du Membre Supérieur, Marseille, France
| | - A Iniesta
- Institut de la Main et du Membre Supérieur, Marseille, France
| | - A Gay
- Institut de la Main et du Membre Supérieur, Marseille, France
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Bertanha L, de Mello CDBF, Damas II, Stelini RF, Di Chiacchio N, Cintra ML. A new technique of paraffin-embedding of formalin-fixed nail sample, obtained by tangential excision - potato as guide mold. An Bras Dermatol 2024; 99:139-141. [PMID: 37657960 DOI: 10.1016/j.abd.2023.01.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Accepted: 01/01/2023] [Indexed: 09/03/2023] Open
Affiliation(s)
- Laura Bertanha
- Faculdade de Ciências Médicas, Universidade Estadual de Campinas, Campinas, SP, Brazil; Hospital do Servidor Público Municipal, São Paulo, SP, Brazil.
| | | | - Ingrid Iara Damas
- Faculdade de Ciências Médicas, Universidade Estadual de Campinas, Campinas, SP, Brazil
| | | | | | - Maria Letícia Cintra
- Faculdade de Ciências Médicas, Universidade Estadual de Campinas, Campinas, SP, Brazil
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Godse R, Rodriguez O, Ayoade KO, Rubin AI. Update on nail unit histopathology. Hum Pathol 2023; 140:214-232. [PMID: 36921726 DOI: 10.1016/j.humpath.2023.03.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2023] [Accepted: 03/08/2023] [Indexed: 03/18/2023]
Abstract
Histopathologic evaluation of the nail unit is an essential component in the diagnosis of nail unit disorders. This review highlights recent updates in nail unit histopathology and discusses literature covering a wide range of nail disorders including melanoma/melanocytic lesions, squamous cell carcinoma, onychomatricoma, onychopapilloma, onychomycosis, lichen planus, and other inflammatory conditions. Herein we also discuss recent literature on nail clipping histopathology, a useful and noninvasive diagnostic tool that continues to grow in popularity and importance to both dermatologists and dermatopathologists.
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Affiliation(s)
- Rama Godse
- Department of Dermatology, Hospital of the University of Pennsylvania, Philadelphia, PA, USA.
| | - Olaf Rodriguez
- Department of Dermatology, Hospital of the University of Pennsylvania, Philadelphia, PA, USA
| | - Katherine Omueti Ayoade
- Department of Dermatology, Hospital of the University of Pennsylvania, Philadelphia, PA, USA
| | - Adam I Rubin
- Department of Dermatology, Hospital of the University of Pennsylvania, Philadelphia, PA, USA
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Samie FH. JAAD Game Changers: Tangential excision of pigmented nail matrix lesions responsible for longitudinal melanonychia: Evaluation of the technique on a series of 30 patients. J Am Acad Dermatol 2023; 88:518. [PMID: 31129218 DOI: 10.1016/j.jaad.2019.05.038] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Accepted: 05/16/2019] [Indexed: 01/17/2023]
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Darmawan CC, Ohn J, Mun J, Kim S, Lim Y, Jo SJ, Kim Y, Kim B, Seong M, Kim BJ, Lee C, Kwak Y, Chung HJ, Virós A, Lee D. Diagnosis and treatment of nail melanoma: A review of the clinicopathologic, dermoscopic, and genetic characteristics. J Eur Acad Dermatol Venereol 2022; 36:651-660. [DOI: 10.1111/jdv.17975] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Revised: 12/20/2021] [Accepted: 01/07/2022] [Indexed: 12/01/2022]
Affiliation(s)
- C. C. Darmawan
- Department of Dermatology Seoul National University College of Medicine 101 Daehak‐ro, Jongno‐gu Seoul 03080 Korea
- Institute of Human‐Environment Interface Biology Seoul National University 101 Daehak‐ro, Jongno‐gu Seoul 03080 Korea
| | - J. Ohn
- Department of Dermatology Seoul National University College of Medicine 101 Daehak‐ro, Jongno‐gu Seoul 03080 Korea
- Institute of Human‐Environment Interface Biology Seoul National University 101 Daehak‐ro, Jongno‐gu Seoul 03080 Korea
| | - J.‐H. Mun
- Department of Dermatology Seoul National University College of Medicine 101 Daehak‐ro, Jongno‐gu Seoul 03080 Korea
- Institute of Human‐Environment Interface Biology Seoul National University 101 Daehak‐ro, Jongno‐gu Seoul 03080 Korea
- Department of Dermatology Seoul National University Hospital 101 Daehak‐ro, Jongno‐gu Seoul 03080 Korea
- Skin Cancer/Chemotherapy Skin Care Center Seoul National University Cancer Hospital 101 Daehak‐ro, Jongno‐gu Seoul 03080 Korea
| | - S. Kim
- Department of Dermatology Seoul National University Hospital 101 Daehak‐ro, Jongno‐gu Seoul 03080 Korea
| | - Y. Lim
- Department of Dermatology Seoul National University Hospital 101 Daehak‐ro, Jongno‐gu Seoul 03080 Korea
- Skin Cancer/Chemotherapy Skin Care Center Seoul National University Cancer Hospital 101 Daehak‐ro, Jongno‐gu Seoul 03080 Korea
| | - S. J. Jo
- Department of Dermatology Seoul National University College of Medicine 101 Daehak‐ro, Jongno‐gu Seoul 03080 Korea
- Institute of Human‐Environment Interface Biology Seoul National University 101 Daehak‐ro, Jongno‐gu Seoul 03080 Korea
- Department of Dermatology Seoul National University Hospital 101 Daehak‐ro, Jongno‐gu Seoul 03080 Korea
- Skin Cancer/Chemotherapy Skin Care Center Seoul National University Cancer Hospital 101 Daehak‐ro, Jongno‐gu Seoul 03080 Korea
| | - Y.‐g. Kim
- Department of Laboratory Medicine Green Cross Genomic Laboratories 107 Ihyeonro 30beon‐gil Giheng‐gu Yongin‐Si Gyeonggi‐do 16924 Korea
| | - B. Kim
- Department of Laboratory Medicine Seoul National University College of Medicine 101 Daehak‐ro, Jongno‐gu Seoul 03080 Korea
| | - M.‐W. Seong
- Department of Laboratory Medicine Seoul National University College of Medicine 101 Daehak‐ro, Jongno‐gu Seoul 03080 Korea
| | - B. J. Kim
- Department of Plastic and Reconstructive Surgery Seoul National University College of Medicine 101 Daehak‐ro, Jongno‐gu Seoul 03080 Korea
| | - C. Lee
- Department of Pathology Seoul National University College of Medicine 101 Daehak‐ro, Jongno‐gu Seoul 03080 Korea
| | - Y. Kwak
- Department of Pathology Seoul National University College of Medicine 101 Daehak‐ro, Jongno‐gu Seoul 03080 Korea
| | - H. J. Chung
- Department of Dermatology Harvard Medical School Boston Massachusetts 02215 USA
| | - A. Virós
- Skin Cancer and Ageing Lab Cancer Research UK Manchester Institute The University of Manchester Manchester SK10 4TG UK
| | - D.Y. Lee
- Department of Dermatology Samsung Medical Center Sungkyunkwan University 81 Irwon‐Ro, Gangnam‐gu Seoul 06351 Korea
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Abstract
Nail unit melanoma is an uncommon form of melanoma with worse prognosis compared with nonacral cutaneous melanoma. Nail unit melanoma is often diagnosed at a late stage. Clinical and dermoscopic features may suggest a diagnosis of nail unit melanoma, but confirmation requires histologic analysis. Like the clinical diagnosis, histopathologic diagnosis of nail unit melanoma is also difficult. The surgical management of nail unit melanoma has evolved from aggressive amputations to digit-sparing approaches. This article reviews the clinical presentation, diagnosis, and surgical treatment of nail unit melanoma to promote early diagnosis and rational surgery.
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Baltz JO, Jellinek NJ. Nail Surgery: Six Essential Techniques. Dermatol Clin 2021; 39:305-318. [PMID: 33745642 DOI: 10.1016/j.det.2020.12.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Successful nail surgery requires an understanding of specific disease processes, the anatomy of the nail unit, and fluency with only a few key techniques. This article focuses on 6 high-yield procedures, facility with which will allow the clinician to approach most of the clinical scenarios requiring surgical intervention. These encompass surgical approaches to inflammatory nail diseases, melanonychia, erythronychia, and nail melanoma in situ.
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Affiliation(s)
- Julia O Baltz
- Dermatology Professionals, Inc, 1672 South County Trail, Suite 101, East Greenwich, RI 02818, USA; Department of Dermatology, University of Massachusetts Medical School, 281 Lincoln Street, Worcester, MA 01605, USA
| | - Nathaniel J Jellinek
- Dermatology Professionals, Inc, 1672 South County Trail, Suite 101, East Greenwich, RI 02818, USA; Department of Dermatology, University of Massachusetts Medical School, 281 Lincoln Street, Worcester, MA 01605, USA; Department of Dermatology, The Warren Alpert Medical School at Brown University, 593 Eddy Street, Providence, RI 02903, USA.
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Modified shave surgery combined with nail window technique for the treatment of longitudinal melanonychia: Evaluation of the method on a series of 67 cases. J Am Acad Dermatol 2019; 81:717-722. [DOI: 10.1016/j.jaad.2019.03.065] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Revised: 03/13/2019] [Accepted: 03/22/2019] [Indexed: 11/30/2022]
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Xue S, Pradhan S. Ropivacaine for modified tangential excision of nail matrix. Dermatol Ther 2019; 32:e12889. [PMID: 30942932 DOI: 10.1111/dth.12889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2018] [Revised: 02/18/2019] [Accepted: 03/26/2019] [Indexed: 02/05/2023]
Affiliation(s)
- Siliang Xue
- Department of Dermatovenereology, West China Hospital, Sichuan University, Chengdu, China
| | - Sushmita Pradhan
- Department of Dermatovenereology, West China Hospital, Sichuan University, Chengdu, China
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A Novel Window Technique Using CO2 Laser, and a Review of Methods for Nail Matrix Biopsy of Longitudinal Melanonychia. Dermatol Surg 2018; 44:651-660. [DOI: 10.1097/dss.0000000000001381] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
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12
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Abstract
Nail biopsy is a procedure not routinely resorted to; but when indicated, it is often the only clue left for diagnosis. At such times, it pays to be conversant with it. It is an investigation that not only provides etiologic, diagnostic, and prognostic information but also aids in understanding the pathogenesis of nail diseases. It can be of therapeutic value, especially with respect to nail tumors. This article compiles the procedural techniques for nail biopsy of various types and attempts to summarize the evidence available in the literature. The objective of nail biopsy is to clinch a precise diagnosis of nail pathology with a simple and safe surgical procedure, avoiding pain or permanent nail damage. Patient selection is of utmost importance, wherein, the patient does not have typical skin lesions, yields inadequate information on routine nail investigations, and has no peripheral vascular compromise. The patient needs to be explained about the risks associated, the expected functional handicap, the time required for regrowth, a possibility of permanent nail dystrophy, and a possibility of not achieving a diagnosis even after the biopsy. Techniques and types of various nail biopsies are being discussed in this article. The specimen could be collected as an excision biopsy, punch biopsy, shave biopsy, or longitudinal biopsy. The trick lies in choosing the appropriate area for biopsy. Various biopsy types discussed in this article include nail plate biopsy (easiest and least scarring); nail bed biopsy (elliptical excision or punch); nail matrix biopsy (elliptical excision, punch excision (≤3 mm) or tangential/shave excision); and nail fold biopsy. Complications reported along with means to minimize them are also discussed.
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Affiliation(s)
- Chander Grover
- Department of Dermatology and STD, University College of Medical Sciences and GTB Hospital, New Delhi, India
| | - Shikha Bansal
- Department of Dermatology and STD, VMMC and Safdarjung Hospital, New Delhi, India
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13
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Lee JH, Park JH, Lee JH, Lee DY. Early Detection of Subungual Melanoma In Situ: Proposal of ABCD Strategy in Clinical Practice Based on Case Series. Ann Dermatol 2017; 30:36-40. [PMID: 29386830 PMCID: PMC5762474 DOI: 10.5021/ad.2018.30.1.36] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2017] [Revised: 05/04/2017] [Accepted: 06/21/2017] [Indexed: 02/03/2023] Open
Abstract
Background Prevalence of subungual melanoma (SUM) in Asian population is relatively high and early clinical detection improves both quality of life and survival. Objective We sought to establish screening strategy for SUM in situ. Methods We retrospectively reviewed medical records of 8 patients pathologically diagnosed as SUM in situ between January 2015 and September 2016. Results All patients in our study were adults and had solitary lesion. In all cases, longitudinal melanonychia as well as background pigmentation in entire nail plate was observed. Seven (87.5%) cases had periungual pigmentation. Clinical features of SUM in situ can be summarized according to new criteria categorized under initial letters of alphabet, namely nail ABCD of SUM in situ; “A” stands for adult age (age >18 years); “B” for brown bands in brown background; “C” for color in periungual skin; “D” for one digit. Our strategy was to suspect SUM in situ if solitary longitudinal melanonychia in adult was satisfying either “B” or “C” in ABCD. All cases were suspected as SUM in situ under nail ABCD rule, and histological examination confirmed diagnosis. Sensitivity and specificity of nail ABCD was 100% and 96.6%, respectively, regarding our previously published 18 SUM in situ and unpublished 28 nail matrix nevi cases as well as 8 SUM in situ presented here. Conclusion ABCD rule is simple and sensitive clinical strategy for early detection of SUM in situ.
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Affiliation(s)
- Jae Ho Lee
- Department of Dermatology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Ji-Hye Park
- Department of Dermatology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jong Hee Lee
- Department of Dermatology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Dong-Youn Lee
- Department of Dermatology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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Maddy AJ, Tosti A. Spontaneous Regression of a Nail Matrix Melanocytic Nevus in a Child. Pediatr Dermatol 2017; 34:e254-e256. [PMID: 28804956 DOI: 10.1111/pde.13231] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
A 14-year-old Hispanic boy presented with a 0.25-mm wide, sharply demarcated, dark brown band of longitudinal melanonychia of the left thumbnail. A clinical diagnosis of nail matrix nevus was made and the boy was scheduled for follow-up. The band showed proximal fading after 6 months and had completely faded after 11 months, with the proximal nail fold showing small dark brown dots on dermoscopy. We documented the spontaneous regression of melanonychia over 11 months.
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Affiliation(s)
- Austin John Maddy
- Department of Dermatology and Cutaneous Surgery, Miller School of Medicine, University of Miami, Miami, Florida
| | - Antonella Tosti
- Department of Dermatology and Cutaneous Surgery, Miller School of Medicine, University of Miami, Miami, Florida
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Frequency of Subungual Melanoma in Longitudinal Melanonychia: A Single-Center Experience. Dermatol Surg 2017; 43:798-804. [DOI: 10.1097/dss.0000000000001112] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Jellinek NJ, Vélez NF. Dermatologic Manifestations of the Lower Extremity: Nail Surgery. Clin Podiatr Med Surg 2016; 33:319-36. [PMID: 27215154 DOI: 10.1016/j.cpm.2016.02.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
Nail surgery is a fundamental component of podiatric surgery. Nail disorders are common and may cause significant morbidity and occasionally mortality. Diagnosis of inflammatory and infectious conditions, and of benign or malignant tumors, often requires a biopsy of the nail unit. Excisional surgery may also be curative for certain tumors. This article reviews key elements of nail anatomy, surgical preparation, local anesthesia, and methods to achieve and maintain a bloodless field. A familiarity with these concepts should allow clinicians to develop a surgical plan and approach when patients present with a nail disorder requiring biopsy or surgical treatment.
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Affiliation(s)
- Nathaniel J Jellinek
- Dermatology Professionals, Inc, 1672 South County Trail, Suite 101, East Greenwich, RI 02818, USA; Department of Dermatology, Warren Alpert Medical School, Brown University, Providence, RI, USA; Division of Dermatology, University of Massachusetts Medical School, Worcester, MA, USA.
| | - Nicole F Vélez
- Westmoreland Dermatology Associates, Monroeville, PA, USA
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Park SW, Jang KT, Lee JH, Park JH, Kwon GY, Mun GH, Lee DY, Lee JB, Park KK. Scattered atypical melanocytes with hyperchromatic nuclei in the nail matrix: diagnostic clue for early subungual melanomain situ. J Cutan Pathol 2015; 43:41-52. [DOI: 10.1111/cup.12634] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2015] [Revised: 09/10/2015] [Accepted: 09/29/2015] [Indexed: 11/28/2022]
Affiliation(s)
- Se-Won Park
- Department of Dermatology, Samsung Medical Center; Sungkyunkwan University School of Medicine; Seoul South Korea
| | - Kee-Taek Jang
- Department of Pathology, Samsung Medical Center; Sungkyunkwan University School of Medicine; Seoul South Korea
| | - Jae-Ho Lee
- Department of Dermatology, Samsung Medical Center; Sungkyunkwan University School of Medicine; Seoul South Korea
| | - Ji-Hye Park
- Department of Dermatology, Samsung Medical Center; Sungkyunkwan University School of Medicine; Seoul South Korea
| | - Ghee Young Kwon
- Department of Pathology, Samsung Medical Center; Sungkyunkwan University School of Medicine; Seoul South Korea
| | - Goo-Hyun Mun
- Department of Plastic Surgery, Samsung Medical Center; Sungkyunkwan University School of Medicine; Seoul South Korea
| | - Dong-Youn Lee
- Department of Dermatology, Samsung Medical Center; Sungkyunkwan University School of Medicine; Seoul South Korea
| | - Jason B. Lee
- Department of Dermatology and Cutaneous Biology; Thomas Jefferson University Hospital; Philadelphia PA USA
| | - Kelly K. Park
- Division of Dermatology; Loyola University Medical Center; Maywood IL USA
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Piraccini BM, Dika E, Fanti PA. Tips for diagnosis and treatment of nail pigmentation with practical algorithm. Dermatol Clin 2015; 33:185-95. [PMID: 25828711 DOI: 10.1016/j.det.2014.12.002] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
The observation of a black-brown pigmentation of the nail is often alarming for the patient and for the clinician, as they are aware that it can be a possible clinical manifestation of melanoma of the nail apparatus. Luckily, however, nail melanoma is a much less frequent cause of brown-black nail color than other melanocytic and nonmelanocytic pigmentations, which include subungual hematoma, exogenous pigmentations, and melanonychia due to benign conditions. A correct clinical history and careful examination help the clinician to distinguish the different conditions and to decide the correct management of melanonychia both in children and in adults.
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Affiliation(s)
- Bianca Maria Piraccini
- Division of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Via Massarenti 1, Bologna 40138, Italy.
| | - Emi Dika
- Division of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Via Massarenti 1, Bologna 40138, Italy
| | - Pier Alessandro Fanti
- Division of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Via Massarenti 1, Bologna 40138, Italy
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