Diagnostic criteria for and clinical review of melanonychia in Korean patients

Jin, Hyunju; Kim, Jeong‐Min; Kim, Gun‐Wook; Song, Margaret; Kim, Hoon‐Soo; Ko, Hyun‐Chang; Kim, Byung Soo; Kim, Moon-Bum

doi:10.1016/j.jaad.2015.12.039

Cited by 30 publications

(32 citation statements)

References 17 publications

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“…Except for melanonychia, [6][7][8][9][10][11][12][13][14] dermoscopy use in nail disorders is poorly established. However, application of this simple non-invasive tool to improve the diagnostic accuracy of OM should be explored.…”

Section: Introductionmentioning

confidence: 99%

A comparative study of onychomycosis and traumatic toenail onychodystrophy dermoscopic patterns

Pinheiro

Domingues²,

Sousa

et al. 2019

Acad Dermatol Venereol

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Background Onychomycosis (OM) and traumatic onychodystrophy (OD) are common causes of toenail changes.A clinical diagnosis is often impossible without mycology. Dermoscopy is helpful in this setting but yet underexplored. Prospective comparative studies between OM and OD onychoscopic findings have not been previously performed.Objectives We sought to determine distinguishing dermoscopic presentations of OM and traumatic OD. MethodsWe performed a prospective, observational study including patients presenting with ≥1 toenail onychodystrophy. All underwent onychoscopy, clinical and mycological examination. Based on these results, patients received a final diagnosis of OM or OD. Dermoscopic presentations of OM and OD patients were classified in patterns and compared.Results In all, 110 cases of OM and 82 of traumatic OD were compared. Statistical analyses revealed that the distal pulverized and the irregular spiked macular dermoscopic patterns were predictors of an OM diagnosis. The regular macular, the non-classifiable, the total and partial homogeneous background dermoscopic patterns correlated with traumatic OD diagnosis. ConclusionsWe demonstrated that OM and traumatic OD have distinctive onychoscopic presentations. Dermoscopy may be an important ancillary tool to guide their differential.

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Section: Introductionmentioning

confidence: 99%

A comparative study of onychomycosis and traumatic toenail onychodystrophy dermoscopic patterns

Pinheiro

Domingues²,

Sousa

et al. 2019

Acad Dermatol Venereol

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“…1–3 While longitudinal melanonychia (LM), a brown-black band of the nail plate, is the most common presenting sign of SM (2/3 of cases), it is not specific for SM. 4 In fact, in one study, only 6.8% cases of LM showed histological evidence of SM, with the remaining cases benign etiologies including subungual hematoma, nail matrix nevus, trauma, nail apparatus lentigo, and melanocytic activation.…”

Section: To the Editormentioning

confidence: 99%

“…4 In fact, in one study, only 6.8% cases of LM showed histological evidence of SM, with the remaining cases benign etiologies including subungual hematoma, nail matrix nevus, trauma, nail apparatus lentigo, and melanocytic activation. 3 Therefore, an ABC mnemonic for SM (A: A ge, A sian, A frican, Native A merican; B: B and, B rown- B lack, B readth ≥ 3mm, B lurred B order; C: C hange; D: D igit, D ominant hand; E: E xtension of pigment to nail folds; F: F amily or personal history melanoma) was developed in 2000 to facilitate early recognition of SM by physicians and the community. 2 …”

Section: To the Editormentioning

confidence: 99%

A survey-based study of management of longitudinal melanonychia amongst attending and resident dermatologists

Halteh

Scher

Artis

et al. 2017

Journal of the American Academy of Dermatology

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“…Total melanonychia describes involvement of the entire nail. Melanonychia is more common in individuals with darker skin phototype, such as those of Asian or Afro‐Caribbean descent, and can often affect several nails . Melanonychia in childhood is usually due to benign melanocytic lesions (e.g, melanocyte activation, lentigo, or melanocytic nevus) .…”

Section: Introductionmentioning

confidence: 99%

“…Persistence or recurrence of the melanonychia can lead to further patient and parental anxiety. The current knowledge regarding the risk of malignancy and long‐term prognosis in children of Asian descent presenting with melanonychia is limited, and as a result, the management of these cases is particularly challenging and controversial …”

Section: Introductionmentioning

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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Diagnostic criteria for and clinical review of melanonychia in Korean patients

Cited by 30 publications

References 17 publications

A comparative study of onychomycosis and traumatic toenail onychodystrophy dermoscopic patterns

A comparative study of onychomycosis and traumatic toenail onychodystrophy dermoscopic patterns

A survey-based study of management of longitudinal melanonychia amongst attending and resident dermatologists

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

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