Malignant melanoma of the nail confers a higher mortality rate compared to other cutaneous melanomas, which is often attributable to delayed diagnosis. Two-thirds of nail melanomas present as longitudinal melanonychia (LM), longitudinally-oriented brown-black bands of pigment in the nail plate. This article delineates the appropriate clinical approach toward evaluation and management of a patient with longitudinal melanonychia, which includes determining risk factors for melanoma, recognizing scenarios in which biopsy is indicated, selecting the appropriate biopsy technique, and managing a patient in whom the diagnosis of nail melanoma has been made.

No abstract

Lichen sclerosus et atrophicus (LSA) is a chronic inflammatory scarring disease with a predilection for the anogenital area; however, 15%-20% of LSA cases are extragenital. The folliculocentric variant is rarely reported and less well understood. The authors report a rare case of extragenital, folliculocentric LSA in a 10-year-old girl. The patient presented to the dermatology clinic for evaluation of an asymptomatic eruption of the arms and legs, with no vaginal or vulvar involvement. Physical examination revealed the presence of numerous 2-4 mm, mostly perifollicular, hypopigmented, slightly atrophic papules and plaques. Many of the lesions had a central keratotic plug. Cutaneous histopathological examination showed features of LSA. Based on clinical and histological findings, folliculocentric extragenital LSA was diagnosed.

No abstract