Evaluation of large cellular remnants of melanocytes in the nail plate: An advancement in the correlation of diagnosis and prognosis for nail unit melanocytic lesions

Rubin, Adam I.; Yun, Sook-Jung; Haneke, Eckart

doi:10.1111/cup.14201

Cited by 2 publications

(4 citation statements)

References 5 publications

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“…A potential pitfall to be aware of is the lack of reliable immunoperoxidase staining in nail plate specimens, 5,6 which may be related to softening techniques. In some cases, S‐100 may serve as a superior marker in highlighting melanocytes in the nail plate but may show variable staining 8 . In addition, dermatopathologists need to use caution when interpreting nail clippings with MR from children, as most melanocytic nail unit pigmented lesions in children are benign.…”

Section: Figurementioning

confidence: 99%

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A call for nail clipping histopathology to become an essential component of the routine evaluation of melanonychia: Benefitting patients as a triage and surgical planning maneuver

Rodriguez

Elenitsas

Jiang³

et al. 2023

J Cutan Pathol

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We call on dermatologists and dermatopathologists to include nail clipping histopathology as an essential component of the routine evaluation of melanonychia. This manuscript demonstrates a case where an adult woman with broad melanonychia of the right thumbnail declined a nail matrix biopsy, but was amenable to a nail clipping.The nail clipping showed pigmentation, melanocyte remnants, and small cavities in the nail plate. These features have been published previously by our group as a clue to nail unit melanoma within nail clippings.This patient was rapidly triaged for nail matrix biopsy, which demonstrated nail unit melanoma in situ. Every patient with melanonychia can benefit from a nail clipping by examination of the location of the pigmentation within the nail plate for surgical planning, and if melanocyte remnants are detected, the nail clipping also serves as a rapid triage mechanism for nail matrix biopsy to evaluate for nail unit melanoma. Fontana-stained sections will highlight the pigmentation in

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Section: Figurementioning

confidence: 99%

“…In some cases, S-100 may serve as a superior marker in highlighting melanocytes in the nail plate but may show variable staining. 8 In addition, dermatopathologists need to use caution when interpreting nail clippings with MR from children, as most melanocytic nail unit pigmented lesions in children are benign.…”

mentioning

confidence: 99%

A call for nail clipping histopathology to become an essential component of the routine evaluation of melanonychia: Benefitting patients as a triage and surgical planning maneuver

Rodriguez

Elenitsas

Jiang³

et al. 2023

J Cutan Pathol

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“…Softening solutions may add additional difficulties in IHC evaluation of pigmented lesions within the nail unit. 24,27,57,58 Softening solutions are often needed to process adult nail specimens that include hard nail plate. The use of softening solutions may present a challenge in the interpretation of immunoperoxidase staining, as the softening solutions may cause false-negative results, and lack of staining of melanocytes.…”

Section: Immunohistochemical Stainingmentioning

confidence: 99%

“…Softening solutions may add additional difficulties in IHC evaluation of pigmented lesions within the nail unit 24,27,57,58 . Softening solutions are often needed to process adult nail specimens that include hard nail plate.…”

Section: Clinical Challengesmentioning

confidence: 99%

Clinicohistopathologic challenges and traps in the diagnosis of nail unit melanoma

Jiang¹,

Abbott

Higgins

et al. 2023

J Cutan Pathol

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Melanoma of the nail apparatus is challenging to diagnose for both dermatologists and dermatopathologists. Misdiagnosis or delayed diagnosis of nail unit melanoma can have fatal consequences and legal ramifications. This review educates dermatopathologists on challenges and traps they should be aware of to avoid misdiagnosis of nail unit melanoma. We present illustrative difficult cases that introduce several themes regarding challenges in the diagnosis of nail unit melanoma: specimens with subtle histopathologic findings, challenges in immunoperoxidase interpretation, and how clinical knowledge and surgical procedural knowledge are mandatory to make the diagnosis. Dermatopathologists will be aware of when and how to suspect nail unit melanoma in unusual circumstances.

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Evaluation of large cellular remnants of melanocytes in the nail plate: An advancement in the correlation of diagnosis and prognosis for nail unit melanocytic lesions

Cited by 2 publications

References 5 publications

A call for nail clipping histopathology to become an essential component of the routine evaluation of melanonychia: Benefitting patients as a triage and surgical planning maneuver

A call for nail clipping histopathology to become an essential component of the routine evaluation of melanonychia: Benefitting patients as a triage and surgical planning maneuver

Clinicohistopathologic challenges and traps in the diagnosis of nail unit melanoma

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