DefinitionThis section has been translated automatically.
Stripy brown/black discoloration (pigmentation) of different origin, rarely occurring in Caucasians, running longitudinally across the nail plate.
Occurrence/EpidemiologyThis section has been translated automatically.
Frequently as melanocytic pigmentation in dark ethnic groups (96% of those over 50!).
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EtiopathogenesisThis section has been translated automatically.
Melanocytes are present in the nail root. These are inactive in Caucasians under physiological conditions. They become active by certain exogenous or endogenous factors and thus melanin-forming. This then leads to nail pigmentation of varying widths and streaks.
Melanocytic, microbiological, tumorous or endogenous factors have been described as triggers:
- Physiologic in dark ethnicities (skin types IV and V).
- Longitudinal melanonychia due to hyperplasia of melanocytes:
- Longitudinal melanonychia due to drugs:
- Longitudinal melanonychia in metabolic diseases:
- Longitudinal melanonychia due to microbiological causes:
- Scopulariopsis brevicaulis
- Trichophyton soudanense
- Alternaria tenuissima
- Fusarium oxysporum
- Scytalidium dimidiatum.
- Bacterial causes:
- Pseudomonas aeruginosa
- Proteus spp.
LocalizationThis section has been translated automatically.
Differential diagnosisThis section has been translated automatically.
TherapyThis section has been translated automatically.
If a malignant melanoma is suspected, a bioptic examination is necessary with appropriate surgical measures. S.u. melanoma, subunguales.
Progression/forecastThis section has been translated automatically.
In case of melanocytic nail pigmentation, an exact and reliable clinical control of the findings (with photo documentation) is necessary.
In most cases it is a harmless anomaly, which can regress even after years of existence (see figure with control photographs).
A subungual malignant melanoma that cannot be excluded - in adults a malignancy rate between 5 and 10% is assumed (Cooper 2015) - shows progressive growth, recognizable by the widening of the pigment strip of a deepening of the staining and signs of onychodystophy (due to the invasive-displacing growth of the tumor into the nail matrix).
In children, melanoma development is an absolute rarity.
However, the diagnosis of "malignancy" is only possible by biopsy (growth disturbance of the nail matrix)....
Note(s)This section has been translated automatically.
LiteratureThis section has been translated automatically.
- Andre J et al (2003) Longitudinal melanonychia. J Am Acad Dermatol 49: 776
- Cooper C et al.(2015) A clinical, histopathologic, and outcome study of melanonychia striata
inchildhood. J Am Acad Dermatol 72:773-779
- Haneke E (1991) Laugier-Hunziker-Baran syndrome. Dermatologist 42: 512-515
- Kreusch J et al (1992) Incident light microscopic evaluation of pigmented nail lesions. Dt Dermatol 7: 1006-1015
- Neynaber S et al (2004) Longitudinal melanonychia associated with hydroxyarbamide ingestion. JDDG 2: 588-591
- Parodi P et al (2003) Desmoplastic melanoma of the nail. Ann Plast Surg 50: 658-662
Prat C et al (2008) Longitudinal melanonychia as the first sign of Addison's disease. J Am Acad Dermatol 58:522-524.
Van Laborde S et al (2000) Developments in the treatment of nail psoriasis, melanonychia striata, and onychomycosis. A review of the literature. Dermatol Clin 18: 37-46
Incoming links (8)Chromonychia; Laugier-hunziker syndrome; Melanonychia; Nail hematoma; Nail organ; Nail pigmentation; Nail pigmentation, striped; Nevus, melanocytic, subungual;
Outgoing links (21)Addison's disease; Antibiotics; Antimalarials; Chloroquine; Cyclophosphamide; Cytostatics (overview); Hemosiderosis cutis; Hyperthyroidism; Laugier-hunziker syndrome; Leopard syndrome; ... Show all
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