Nail Disorders in Children

Longitudinal Melanonychia

Symptoms

Longitudinal melanonychia is the occurrence of tan, brown, or black pigmented bands along the length of the nail bed. It occurs most often in dark-skinned individuals, and it affects girls more often than boys. These lesions usually represent nail matrix nevi.

Diagnosis

Longitudinal melanonychia is a result of melanin deposition in the nail plate. This accumulation may be due to melanocyte activation, benign melanocyte hyperplasia, or melanoma. In children, most bands are caused by melanocytic hyperplasia. Nevertheless, a careful history, physical exam, and biopsy of the lesion may be necessary to make the correct etiologic diagnosis and to rule out melanoma (Jellinek, 2007).

Treatment

If the hyperpigmentation was induced by pharmaceuticals, the lesions are often reversible upon completion of the drug. However, surgical excision of the lesion is the only definite cure (Léauté-Labrèze, Bioulac-Sage, & Taïeb, 1996).

Patient Education

Longitudinal melanonychia are rare in Caucasian children, and their etiology is therefore more concerning for melanoma. Biopsy and surgical excision will often be performed more aggressively than in children of color.

Dermatology Nursing. 2010;22(1) © 2010  Jannetti Publications, Inc.