Dermoscopic examination of the nail bed and matrix

Hirata, Sérgio Henrique; Yamada, Sérgio; Almeida, Fernando Augusto de; Enokihara, Mauro Yoshiaki; Rosa, Ival Peres; Enokihara, Mílvia M. S. S.; Michalany, Nílceo Schwery

doi:10.1111/j.1365-4632.2004.02335.x

Cited by 58 publications

(48 citation statements)

References 5 publications

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“…65 Therefore, these nevi are referred to as nevi of special body sites and show a pseudonetwork pattern (face), 18,27 parallel furrow pattern (acral areas), [30][31][32][35][36][37]66 regular bandlike pattern (nails), 33,34,[67][68][69] and a globular mixed pattern (mucosa). [70][71][72][73] For mucosal nevi, no specific studies have been performed yet to our knowledge.…”

Section: Special Sitesmentioning

confidence: 99%

Using Dermoscopic Criteria and Patient-Related Factors for the Management of Pigmented Melanocytic Nevi

Zalaudek

Docimo

Argenziano³

2009

Arch Dermatol

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Objective: To review recent dermoscopy studies that provide new insights into the evolution of nevi and their patterns of pigmentation as they contribute to the diagnosis of nevi and the management of pigmented melanocytic nevi. Data Sources: Data for this article were identified by searching the English and German literature by Medline and Journals@Ovid search for the period 1950 to January 2009. Study Selection: The following relevant terms were used: dermoscopy, dermatoscopy, epiluminescence microscopy (ELM), surface microscopy, digital dermoscopy, digital dermatoscopy, digital epiluminescence microscopy, digital surface microscopy, melanocytic skin lesion, nevi, and pigmented skin lesions. There were no exclusion criteria. Data Synthesis: The dermoscopic diagnosis of nevi relies on the following 4 criteria (each of which is characterized by 4 variables): (1) color (black, brown, gray, and blue); (2) pattern (globular, reticular, starburst, and homogeneous blue pattern); (3) pigment distribution (multifocal, central, eccentric, and uniform); and (4) special sites (face, acral areas, nail, and mucosa). In addition, the following 6 factors related to the patient might influence the pattern of pigmentation of the individual nevi: age, skin type, history of melanoma, UV exposure, pregnancy, and growth dynamics. Conclusions: The 4×4×6 “rule” may help clinicians remember the basic dermoscopic criteria of nevi and the patient-related factors influencing their patterns. Dermoscopy is a useful technique for diagnosing melanocytic nevi, but the clinician should take additional factors into consideration to optimize the management of cases of pigmented lesions.

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Section: Special Sitesmentioning

confidence: 99%

Using Dermoscopic Criteria and Patient-Related Factors for the Management of Pigmented Melanocytic Nevi

Zalaudek

Docimo

Argenziano³

2009

Arch Dermatol

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“…With an intraoperative method, a Brazilian group identified 4 dermoscopic patterns: (1) a regular gray pattern, typical of hypermelanosis; (2) a regular brown pattern, typical of benign melanocytic hyperplasia; (3) a regular brown pattern with globules or blotches, typical of melanocytic nevi; and (4) an irregular pattern, typical of melanoma. The use of an intraoperative procedure permitted selecting the best site for performing a biopsy [37]. The gold standard for a definitive diagnosis of nail pigmentation is histopathology [38,39].…”

Section: Alterations Of the Nail Platementioning

confidence: 99%

Dermoscopy in the Evaluation of Nail Disorders

Alessandrini

Starace

Piraccini³

2017

Skin Appendage Disord

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Nail dermoscopy was initially used only in the assessment of nail pigmentation, but now it is widely utilized for the evaluation of many nail disorders. In daily practice, dermoscopy may confirm clinical diagnoses and guides in the management of nail diseases and treatments, permitting a better visualization of symptoms. Dry dermoscopy is required for evaluation of the nail plate surface, while gel as an interface is necessary for assessment of nail pigmentation and onycholysis, as well as for the evaluation of the distal nail margin. In this review, we describe the dermoscopic features of the most important nail disorders, looking at the different areas of the nail. Dermatoscopic changes that usually accompany specific nail diseases are also reviewed.

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“…Dermatoscopic examination of the nail bed and matrix enables the visualization of pigmentation directly in its original site, revealing aspects not observed when the nail plate is interposed between the pigmented lesion and the dermatoscope. However, no correlation was found between the structures observed directly in the matrix and standard dermatoscopic findings in the nail plate [17]. …”

Section: Discussionmentioning

confidence: 99%

Nail Matrix Melanoma in situ: Conservative Surgical Management

Duarte¹,

Correia²,

Barros³

et al. 2009

Dermatology

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Background: Nail unit melanoma (NUM) is a rare variant of acral lentiginous melanoma. The differential diagnosis is wide but an acquired brown streak in the nail of a fair-skinned person must be considered a potential melanoma. Dermatoscopy helps clinicians to more accurately decide if a nail apparatus biopsy is necessary. Methods: We report the case of a 61-year-old Caucasian woman with melanonychia occupying the central portion of the right thumbnail plate with 1 year of evolution. Dermatoscopy showed a brown pigmentation overlaid by longitudinal irregular lines. An excisional biopsy was performed, and pathological examination revealed melanoma in situ. For safety reasons, the nail unit was totally removed down to the phalangeal bone 3 weeks later, and a full-thickness skin graft taken from the arm was used for reconstruction. Conclusion: NUMs pose a difficult treatment challenge. Wide excision with phalanx amputation is not satisfactory for patients with in situ and early invasive melanoma. Full-thickness skin grafting after total nail unit excision is a simple procedure providing a good functional and cosmetic outcome.

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Dermoscopic examination of the nail bed and matrix

Cited by 58 publications

References 5 publications

Using Dermoscopic Criteria and Patient-Related Factors for the Management of Pigmented Melanocytic Nevi

Using Dermoscopic Criteria and Patient-Related Factors for the Management of Pigmented Melanocytic Nevi

Dermoscopy in the Evaluation of Nail Disorders

Nail Matrix Melanoma in situ: Conservative Surgical Management

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