Clinical and dermoscopic clues to differentiate pigmented nail bands: an International Dermoscopy Society study

Benati, Elisa; Ribero, Simone; Longo, Caterina; Piana, Simonetta; Puig, Susana; Carrera, Cristina; Cicero, Francesca; Kittler, Harald; Deinlein, Teresa; Zalaudek, Iris; Stolz, Wilhelm; Scope, Alon; Pellacani, Giovanni; Moscarella, Elvira; Piraccini, Bianca Maria; Starace, Michela; Argenziano, Giuseppe

doi:10.1111/jdv.13991

Cited by 70 publications

(65 citation statements)

References 13 publications

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“…To overcome these limitations and increase the accuracy of diagnosis, the International Study Group on Melanonychia published official consensus statements with over a dozen diagnostic pearls based on dermoscopic images of the nail plate and hyponychium . In 2016, the International Dermoscopy Society reported clinical and dermoscopic clues to differentiate pigmented nail bands . Based on their original study, melanoma cases were significantly associated with six features: (i) width of the pigmented band of more than two‐thirds of the nail plate; (ii) gray and black coloration; (iii) irregularly pigmented lines; (iv) Hutchinson's and micro‐Hutchinson's signs; (v) nail dystrophy; and (vi) granular pigmentation.…”

Section: Dermoscopic Features Of Adult Melanonychiamentioning

confidence: 99%

“…18 In 2016, the International Dermoscopy Society reported clinical and dermoscopic clues to differentiate pigmented nail bands. 19 Based on their original study, melanoma cases were significantly associated with six features: (i) width of the pigmented band of more than two-thirds of the nail plate; (ii) gray and black coloration; (iii) irregularly pigmented lines; (iv) Hutchinson's and micro-Hutchinson's signs;…”

Section: Dermoscopic Features Of Adult Melanonychiamentioning

confidence: 99%

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Dermoscopic evaluation of melanonychia

Koga

2017

The Journal of Dermatology

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The prevalence of melanonychia is approximately 1%, and it is a common symptom encountered in daily practise. However, it may also be the first symptom of melanoma of the nail apparatus. Evaluation of adult melanonychia with clinical information and clinical images is sometimes difficult for clinicians. Dermoscopic observation provides important information based on the algorithm method. Melanonychia in children requires a different approach, because dermoscopic features observed in adult nail apparatus melanoma are generally observed in benign pediatric cases.

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Section: Dermoscopic Features Of Adult Melanonychiamentioning

confidence: 99%

Section: Dermoscopic Features Of Adult Melanonychiamentioning

confidence: 99%

Dermoscopic evaluation of melanonychia

Koga

2017

The Journal of Dermatology

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“…The conditions in which dermoscopy is not performable are thickened nails, blurred borders of the lesions, and a totally black nail plate [34]. A recent study [35] demonstrated a strong association between clinical and dermoscopic findings in nail band pigmentation, helping to distinguish whether a band is benign or malignant. The authors identify 3 important dermoscopic patterns that could help in this distinction: (1) the width of the band, involving more than two-thirds of the nail plate in melanoma; (2) the presence of a gray-to-black color; and (3) the presence of nail dystrophy, which increases the risk of detecting a nail melanoma 3 times.…”

Section: Alterations Of the Nail Platementioning

confidence: 99%

Dermoscopy in the Evaluation of Nail Disorders

Alessandrini

Starace

Piraccini³

2017

Skin Appendage Disord

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Nail dermoscopy was initially used only in the assessment of nail pigmentation, but now it is widely utilized for the evaluation of many nail disorders. In daily practice, dermoscopy may confirm clinical diagnoses and guides in the management of nail diseases and treatments, permitting a better visualization of symptoms. Dry dermoscopy is required for evaluation of the nail plate surface, while gel as an interface is necessary for assessment of nail pigmentation and onycholysis, as well as for the evaluation of the distal nail margin. In this review, we describe the dermoscopic features of the most important nail disorders, looking at the different areas of the nail. Dermatoscopic changes that usually accompany specific nail diseases are also reviewed.

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“…However, this has not been validated in children and may not be representative due to differences in nail plate size. It has been suggested that a more accurate measure may be grouping the width of pigmentation into three groups: less than 1/3, between 1/3 and 2/3, and more than 2/3 of the width of the nail . Most subungual melanomas involve more than 2/3 of the nail plate.…”

Section: Discussionmentioning

confidence: 99%

“…It has been suggested that a more accurate measure may be grouping the width of pigmentation into three groups: less than 1/3, between 1/3 and 2/3, and more than 2/3 of the width of the nail. 11 Most subungual melanomas involve more than 2/3 of the nail plate. This method remains to be validated in children.…”

Section: Discussionmentioning

confidence: 99%

Should we biopsy melanonychia striata in Asian children? A retrospective observational study

Tan

Wang

Seghers

et al. 2019

Pediatric Dermatology

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Background and Objectives Melanonychia striata is common in children of darker‐skinned Asian races, while subungual melanoma is extremely rare and it is difficult to make a diagnosis clinically. However, performing nail unit biopsies in children is particularly challenging and can result in permanent nail dystrophy. The aim of this study was to review the clinical and histologic characteristics of melanonychia striata in pediatric patients of Asian descent to aid in the clinical decision regarding nail biopsy. Methods Sixty‐two pediatric patients presenting with melanonychia striata involving single or multiple nails at two tertiary pediatric dermatology clinics in Singapore between 2005 and 2015 were reviewed. Clinical and histopathological data were analyzed, including age at onset, age at presentation, location, color, width, presence of Hutchinson's sign, pseudo‐Hutchinson's sign, nail dystrophy, length of follow‐up, and clinical evolution. Histopathological assessment was performed by three senior dermatopathologists independently for cases that underwent a nail biopsy. Results No cases of subungual melanoma were detected in our series. Solitary melanonychia of the thumbnail with a single uniform color was the most common presentation. Pseudo‐Hutchinson's sign was commonly observed. Consensus in histological diagnosis emerged amongst all three dermatopathologists in only half of the cases biopsied. Conclusion The occurrence of melanoma in Asian children presenting with melanonychia is extremely rare. We recommend clinical follow‐up and anticipatory guidance for these patients and nail unit biopsy only in the presence of high‐risk clinical features.

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Clinical and dermoscopic clues to differentiate pigmented nail bands: an International Dermoscopy Society study

Abstract: Dermoscopic examination of longitudinal melanonychia provides useful information that could help clinicians to improve melanoma recognition.

Cited by 70 publications

References 13 publications

Dermoscopic evaluation of melanonychia

Dermoscopic evaluation of melanonychia

Dermoscopy in the Evaluation of Nail Disorders

Should we biopsy melanonychia striata in Asian children? A retrospective observational study

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