Korean J Dermatol.
2006 Dec;44(12):1391-1396.
A Clinicopathologic Study of Melanonychia
- Affiliations
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- 1Department of Dermatology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. susini@naver.com
Abstract
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BACKGROUND: Melanonychia is a darkening of the nail caused by deposition of melanin or other substances such as exogenous materials, microorganisms, drugs, PUVA, benign elanocytic hyperplasia or nevus, and malignant melanoma.
OBJECTIVE
The purpose of this study was to describe the clinicopathologic features of melanonychia.
METHODS
We reviewed the medical records, clinical photographs, and histopathologic slides of 25 cases of melanonychia from April 1995 to April 2006 in our department.
RESULTS
The most common clinical pattern of pigmentation was longitudinal melanonychia (13 cases), followed by diffuse (9 cases), and focal melanonychia (3 cases). The final histopathologic diagnoses were fungal infection (4 cases), hemorrhage (2 cases), benign melanocytic hyperplasia (5 cases), melanocytic hyperplasia with nuclear atypia (4 cases), melanoma (5 cases), and no specific findings (5 cases). Of 13 cases of longitudinal melanonychia, 4 cases were benign melanocytic hyperplasia, 3 were melanocytic hyperplasia with nuclear atypia and 3 were malignant melanoma. In diffuse melanonychia, 3 were fungal melanonychia and 2 were melanoma. Three cases of focal melanonychia were associated with fungal infection, hemorrhage or no specific findings respectively.
CONCLUSION
This study demonstrated variable clinicopathologic features of melanonychia. For the good management of melanonychia, dermatologists should be aware of the various clinical and histopathological features of this condition and recommend nail biopsy for early detection of melanoma when it is necessary.
