A Blue-Gray Subungual Discoloration—Quiz Case

Nail Unit Blue Nevi: A 11-Case Series and Review of the Literature

“…One of the cases with proximal matrix involvement was associated with distal plate fissuring. Several cases were also described with distal fissure and longitudinal groove [9, 11, 13-16]. Four patients had a blue nevus extending in the nail bed.…”

Subungual blue nevus

“…Of the 12 case reports of subungual blue nevi found in the English literature with well-described pathologic characterization from 1985 to present, ten were from patients under the age of 60, with four of those patients reported having the lesions since childhood or birth. [5][6][7][8][9][10][11][12][13][14][15][16][17] Of the two cases in patients over the age of 60, the lesions had been present for three years or less, highlighting that nevi may be acquired later in life infrequently. Nine of the 12 cases occurred in women.…”

“…Nine of the cases were associated with pigmentary changes, which included longitudinal melanonychia and scattered pigmented streaks 5,9,13,14,16 and structural changes such as dystrophy, erosion, brittleness or pseudo-clubbing. 6,7,11,12,17 Common blue nevi were the most frequently described subtypes, followed by the cellular and combined variants ( Table 1).…”

Subungual and periungual congenital blue naevus

“…3 Blue naevi of the nail matrix are a rare entity, with only 10 cases described in the literature. [4][5][6][7][8][9][10][11][12] Malignant melanoma should always be considered in the differential diagnosis of subungual melanocytic lesions, as it carries a very poor prognosis. The presence of blue discolouration in and around the single nail unit should alert the clinician to pursue additional work-up, as recently elucidated by two cases of subungual malignant melanoma initially diagnosed as cellular blue naevi.…”