Laugier-Hunziker syndrome: an important differential diagnosis for Peutz-Jeghers syndrome

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“…When affected, one or two homogenous, longitudinal stripes may appear on the nail plate, affecting it either partially or completely. 1,[5][6][7] Diagnosis is clinical and was reached following the exclusion of all other causes of mucocutaneous hyperpigmentation commonly associated with longitudinal melanonychia. 1 The pathology of this condition consists of hyperpigmentation of the basal layer, an increase in melanophages and the presence of pigmentary incontinence in the papillary dermis, with no hyperproliferation or melanocytic atypia.…”

“…1 The pathology of this condition consists of hyperpigmentation of the basal layer, an increase in melanophages and the presence of pigmentary incontinence in the papillary dermis, with no hyperproliferation or melanocytic atypia. 2,6,7 The disorder is more evident in the areas most affected. 2 Mild acanthosis has been described in some reports.…”

“…2 Various conditions should be included in the differential diagnosis of mucocutaneous pigmentary disorders such as the following syndromes: McCune-Albright, LEOPARD, Addison, LAMB, Gardner, Cronkhite-Canada, neurofibromatosis and Peutz-Jeghers, as well as racial pigmentation, which is a benign disorder and the principal cause of longitudinal melanonychia. 1,6,7,8 Nail disorders may be caused by fungi such as Scytalidium dimidiatum, Fusarium spp, Wangiella dermatitidis, Exophiala dermatitidis, Scopulariopsis brevicaulis, Aspergillus niger, Alternaria sp, Penicillium sp and Acremonium sp; however, nail disorders have also been reported to have been caused by the Trichophyton rubrum dermatophyte and by yeasts (Candida spp). 8 Melanonychia may also be a consequence of the use of certain drugs, principally tetracycline, minocycline, antimalarials, phenothiazines and chemotherapeutic agents.…”

“…8 Melanonychia may also be a consequence of the use of certain drugs, principally tetracycline, minocycline, antimalarials, phenothiazines and chemotherapeutic agents. 7 Of all the causes of localized mucosal pigmentation, the most important is amalgam tattoo, melanoma and Kaposi's sarcoma. These conditions are easily excluded by associated clinical findings and supplementary tests.…”

“…These conditions are easily excluded by associated clinical findings and supplementary tests. 1,2,5,7,9 Hutchinson's sign is always present in the case of subungual melanomas; however, it may be present in Peutz-Jeghers and Laugier-Hunziker syndromes, subungual hematoma, racial pigmentation and AIDS, in association with the use of certain drugs such as minocycline and zidovudine, and in Bowen's disease. 9,10 No treatment is required, since the condition is not associated with systemic diseases or complications.…”