Melanonychia associated with PUVA therapy

Ledbetter, Leslie S.; Hsu, Sylvia

doi:10.1067/mjd.2003.117

Cited by 21 publications

(10 citation statements)

References 6 publications

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“…Patients with darker phototypes also more commonly have longitudinal melanonychia resulting from nail trauma or inflammation. Nail biting, 57 friction, 58 inflammatory diseases such as psoriasis and systemic lupus erythematosus, 59 hydroxyurea treatment, 60 psoralen plus ultraviolet A, 61 pregnancy, 62 and drugs (among which chemotherapeutics are most common) 63 have all been associated with melanotic pigmentation of the nail resulting from stimulation of melanocytes (Fig 6). In drug-induced melanonychia, pigmentation will usually fade over months to years after withdrawal of the offending agent.…”

Section: Differential Diagnosismentioning

confidence: 97%

Fungal melanonychia

Finch

Arenas

Baran

2012

Journal of the American Academy of Dermatology

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Fungal melanonychia is a relatively rare nail disorder caused by nail infection that produces brown-to-black pigmentation of the nail unit. The number of organisms implicated as etiologic agents of fungal melanonychia is increasing, and the list currently tops 21 species of dematiaceous fungi and at least 8 species of nondematiaceous fungi. These superficial infections may clinically mimic subungual melanoma and are often not responsive to traditional antifungal therapy. This article reviews the literature on fungal melanonychia and the role of fungal melanin in infection.

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Section: Differential Diagnosismentioning

confidence: 97%

Fungal melanonychia

Finch

Arenas

Baran

2012

Journal of the American Academy of Dermatology

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“…The occurrence of pigmentary changes, especially lentigines and pigmented nail band, nail dystrophy, and nail shedding, is well documented in patients during PUVA therapy and electron-beam radiation [11,13,14]. …”

Section: Discussionmentioning

confidence: 99%

Nail Changes in Early Mycosis Fungoides

Ehsani

Nasimi

Azizpour

et al. 2017

Skin Appendage Disord

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Background: Mycosis fungoides (MF) has a wide range of clinical presentations and it has been reported rarely to involve the nail apparatus. Objective: We intended to evaluate the frequency and characteristics of nail changes in patients with biopsy-proven MF. Methods: A retrospective analysis of 60 patients with MF who were evaluated at our cancer center from 2013 to 2014 was performed to identify patients with nail changes. Histological examinations of the skin around the nail apparatus were obtained from 10 patients with periungual skin erythema and scaling. Results: In 45 patients out of 60 cases, the skin around the nail apparatus was normal, and only in 5 patients of these 45 cases, nail changes were detected. These changes included leukonychia, longitudinal ridging, nail thickening, and opacity. In the remaining 15 patients, erythema and scaling was observed in periungual skin, and 13 of them demonstrated nail changes including longitudinal ridging, nail thickening, fragility of the nail plate, subungual hyperkeratosis, pigmented nail band, Beau's lines, onychomadesis, koilonychia, nail thinning, distal notching, subungual debris, leukonychia, and pitting. In biopsies of periungual skin, none of 10 cases revealed histological findings consistent with MF. Conclusions: Evidence of nail changes was observed in 18 cases (30%). The most common nail changes detected in MF patients included longitudinal ridging, nail thickening, nail fragility, and leukonychia.

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“…Furthermore, her a.m. cortisol levels had been checked periodically and found to be within normal limits. While reports of melanonychia associated with photochemotherapy have been published [4,5], it is unlikely that the negligible concentration of psoralen in the blood after extracorporeal photopheresis treatments may have played a role in the development of polydactilous melanonychia.…”

Section: Figmentioning

confidence: 99%