Immunohistochemical identification of nail matrix melanocytes

Rodríguez, Gerzaín; Vargas, Elga Johanna; Abaúnza, María Claudia; Díaz-Quijano, Diana Marcela; Melo-Uribe, Mario Alexander

doi:10.1111/jdv.14925

Cited by 5 publications

(4 citation statements)

References 22 publications

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“…13,31,[41][42][43][44] Within the proximal nail matrix, melanocytes may be found in the suprabasal layers and are difficult to distinguish from adjacent keratinocytes. 13,30,[44][45][46][47] These features make interpreting pagetoid spread and melanocyte crowding difficult.…”

Section: Evaluation Of Atypiamentioning

confidence: 99%

“…Concerning architectural features of NUM include increased melanocyte count, confluence of melanocytes, florid pagetoid spread, predominance of single units, multinucleated melanocytes, or poor circumscription 13,31,41–44 . Within the proximal nail matrix, melanocytes may be found in the suprabasal layers and are difficult to distinguish from adjacent keratinocytes 13,30,44–47 . These features make interpreting pagetoid spread and melanocyte crowding difficult.…”

Section: Clinical Challengesmentioning

confidence: 99%

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Clinicohistopathologic challenges and traps in the diagnosis of nail unit melanoma

Jiang¹,

Abbott

Higgins

et al. 2023

J Cutan Pathol

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Melanoma of the nail apparatus is challenging to diagnose for both dermatologists and dermatopathologists. Misdiagnosis or delayed diagnosis of nail unit melanoma can have fatal consequences and legal ramifications. This review educates dermatopathologists on challenges and traps they should be aware of to avoid misdiagnosis of nail unit melanoma. We present illustrative difficult cases that introduce several themes regarding challenges in the diagnosis of nail unit melanoma: specimens with subtle histopathologic findings, challenges in immunoperoxidase interpretation, and how clinical knowledge and surgical procedural knowledge are mandatory to make the diagnosis. Dermatopathologists will be aware of when and how to suspect nail unit melanoma in unusual circumstances.

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Section: Evaluation Of Atypiamentioning

confidence: 99%

Section: Clinical Challengesmentioning

confidence: 99%

Clinicohistopathologic challenges and traps in the diagnosis of nail unit melanoma

Jiang¹,

Abbott

Higgins

et al. 2023

J Cutan Pathol

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“…suggested that an increased number of scattered atypical melanocytes with large hyperchromatic nuclei in a partial nail matrix may provide a diagnostic clue to NMIS, when there is strong clinical suspicion. As the identification of melanocytes in the nail matrix is often difficult, immunohistochemistry staining with Melan‐A (MART‐1), HMB45, S‐100, SOX‐10, or MiTF is useful 24,57,58 . It should be noted that the sensitivity of the S‐100 protein immunostain is weak for intraepithelial melanocytes of the nail matrix, although it is more sensitive for dermal component than HMB‐45 and Melan‐A 59 …”

Section: Histopathology Findingsmentioning

confidence: 99%

“…As the identification of melanocytes in the nail matrix is often difficult, immunohistochemistry staining with Melan-A (MART-1), HMB45, S-100, SOX-10, or MiTF is useful. 24,57,58 It should be noted that the sensitivity of the S-100 protein immunostain is weak for intraepithelial melanocytes of the nail matrix, although it is more sensitive for dermal component than HMB-45 and Melan-A. 59 The presence of inflammatory cell infiltration favors early NM compared to benign melanonychia, as it indicates an oncogenic response to malignant melanocytes.…”

Section: Histopathology Findingsmentioning

confidence: 99%

Diagnosis and treatment of nail melanoma: a review of the clinicopathologic, dermoscopic, and genetic characteristics

Darmawan

Ohn

Mun

et al. 2022

Acad Dermatol Venereol

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Nail melanoma (NM) is an important differential diagnosis in patients with longitudinal melanonychia. However, diagnosis is often challenging as it is difficult to differentiate from other pigmented nail disorders. The main challenge for diagnosis is obtaining adequate nail matrix biopsy specimens for histopathological assessment. Furthermore, the histopathological changes in the early stages of NM are subtle and contribute to a delay in diagnosis and care. Therefore, the integration of clinical and histopathological analyses is essential. Clinical and dermoscopic features, such as a broadened width of asymmetric bands in an irregular pattern, with multicolour pigmentation, periungual pigmentation, and continuous growth, are features that support the diagnosis of NM. The essential histological features that must be assessed are cellular morphology, architectural features, melanocyte density, and inflammatory changes. The reported mutations in NMs were BRAF (0–43%), NRAS (0–31%), KIT (0–50%), NF1 (0–50%), and GNAQ (0–25%). Surgery is the primary treatment for NM. The recommended treatment for in situ or minimally invasive NM is functional surgery, but cases with suspected bone invasion should be treated with amputation. Targeted therapy and immunotherapy are indicated for advanced stages of NM. This review summarizes the updated guidelines for the diagnosis and treatment of NM.

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Acquired Disorders of the Nails and Nail Unit

Pasch,

Richert,

Iorizzo

2024

Rook's Textbook of Dermatology

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Diseases of the nail unit may have numerous causes that reflect dermatology as a whole but often present in a unique way. This chapter attempts to increase insight into the pathophysiology of the expression of nail abnormalities. It also focuses on many groups of nail disease, including traumatic nail disorders, tumours of and around the nail unit, perionychial disorders, age‐related nail abnormalities, and frequent dermatoses affecting the nails, such as nail psoriasis, eczema and lichen planus. Imaging of the nail, nail surgery and some cosmetic aspects of nail care are also discussed.

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Immunohistochemical identification of nail matrix melanocytes

Cited by 5 publications

References 22 publications

Clinicohistopathologic challenges and traps in the diagnosis of nail unit melanoma

Clinicohistopathologic challenges and traps in the diagnosis of nail unit melanoma

Diagnosis and treatment of nail melanoma: a review of the clinicopathologic, dermoscopic, and genetic characteristics

Acquired Disorders of the Nails and Nail Unit

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