What is the prognosis of melanonychia?

Updated: Sep 10, 2018
  • Author: Chris G Adigun, MD, FAAD; Chief Editor: William D James, MD  more...
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In cases of melanonychia associated with systemic diseases, treatment of the primary condition may improve the nail pigmentation. Similarly, discontinuation of any offending drugs may improve melanonychia.

The prognosis of patients with subungual melanoma is poor. In a 2007 series of 106 subungual melanomas, 48 (45%) patients developed a recurrence or metastasis and, of these, 33 (69%) died from their disease during the follow-up period (median 56 mo). Patients with a melanoma deeper than 2.5 mm had a statistically worse survival rate than those with thin melanomas. Melanonychia secondary to subungual melanoma has the highest morbidity and mortality compared with other body sites, with reported 5- and 10-year survival rates of 30% and 13%, respectively. [13]

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