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.
Cite this: Nail Disorders in Children - Medscape - Jan 01, 2010.
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