Melanonychia, melanocytic hyperplasia, and nail melanoma in a Hispanic population

Domínguez‐Cherit, Judith; Roldán–Marín, Rodrigo; Pichardo-Velázquez, Patricia; Valente, Celeste; Fonte-Avalos, Verónica; Vega‐Memije, María Elisa; Toussaint–Caire, Sonia

doi:10.1016/j.jaad.2008.07.012

Cited by 39 publications

(22 citation statements)

References 17 publications

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“…It was found that 4.3% of LM were melanoma in a mestizo Hispanic population in Mexico [7]. In contrast, LM caused by melanoma in children is extremely rare, with only a few cases having been reported [8][9][10][11].…”

Section: Introductionmentioning

confidence: 99%

Longitudinal Melanonychia: Differences in Etiology Are Associated with Patient Age at Diagnosis

Tseng¹,

Liang²,

Liau³

et al. 2017

Dermatology

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Background: Longitudinal melanonychia (LM) may occur as a result of nail apparatus melanoma. Knowledge of etiology plays an important role in the management of LM. Objectives: The study is aimed to compare the diagnosis of LM in different age groups. Methods: We collected 63 cases (45 adults and 18 children) with LM who underwent nail matrix biopsy or excision in a 21-year cohort and assessed their clinicopathological features. Results: Melanomas in adults and children were 40% and none, while nevi accounted for 15.6% in adults and 94.4% in children. There was a statistically significant difference between the average age at diagnosis for melanoma (54.5 ± 13.3 years) and nevus (15.2 ± 18.5 years). Logistic regression related the occurrence of melanoma to older ages with a relative risk of 1.2 compared to nevus, but no cutoffs between age groups could be deﬁned between LM-associated nevus and melanoma. Conclusion: The adult group has a significantly higher risk of melanoma, while children with LM show mostly nonmelanoma etiologies. Tissue proof is more warranted in adult cases, and it is needed in selected cases of children with LM.

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Section: Introductionmentioning

confidence: 99%

Longitudinal Melanonychia: Differences in Etiology Are Associated with Patient Age at Diagnosis

Tseng¹,

Liang²,

Liau³

et al. 2017

Dermatology

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“…As expected and in accordance to most previous studies, melanoma presented exclusively as a single band (Baran and de Berker, 2010, Carreño et al, 2013, Molina and Sanchez, 1995, Perrin, 2013, Ruben, 2010, Tosti et al, 2012). Interestingly, two out of three melanoma cases reported by Dominguez-Cherit et al (2008) had LM in more than one finger (Dominiguez-Cherit et al, 2008). This suggests that the presence of racial melanonychia in multiple nails does not rule out melanoma and that all lesions need to be properly investigated.…”

Section: Discussionmentioning

confidence: 99%

“…Although pigmented bands on the nail can be caused by hemorrhage, infections, drugs, etc., the brown-black appearance in LM is commonly caused by melanin deposition in the nail plate (Baran and Kechijian, 1989, Di Chiacchio et al, 2013a, Di Chiacchio et al, 2013b, Sohn et al, 2015). Melanocytes of the nail are primarily located in the suprabasal layer of the matrix, and melanin is produced by these melanocytes (Baran and de Berker, 2010, Dominguez-Cherit et al, 2008, Theunis et al, 2011). …”

Section: Introductionmentioning

confidence: 99%

“…In melanocytic activation, the number of melanocytes in the nail matrix is not increased, but the melanin content that is deposited in the nail plate is more than usual (Ruben, 2010). Racial melanonychia, a very common form of melanonychia, is mostly the result of this process and is seen commonly in blacks and Asians (Dominguez-Cherit, et al 2008;Elder et al, 2008). Melanocytic hyperplasia is a benign process in which the number of nail melanocytes is moderately increased and the resulting lesion is a lentigo.…”

Section: Introductionmentioning

confidence: 99%

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Longitudinal melanonychia in an Iranian population: a study of 96 patients

Kamyab

Abdollahi

Nezam-Eslami

et al. 2016

International Journal of Women's Dermatology

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BackgroundLongitudinal melanonychia (LM) can be a challenging sign since it may be caused by a wide variety of benign and malignant conditions. Cutaneous melanoma is the most important cause of LM. Objective: We performed this study to examine different aspects of LM in Iran, where cutaneous melanoma is rare.MethodsIn this cross-sectional study, we reviewed medical records and pathology reports of a total of 96 patients presenting with LM. These patients had been visited and undergone nail biopsy in Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran. Demographic, clinical, and pathological data were recorded.ResultsThe most common diagnosis was junctional nevi in 28 patients (29.2%) followed by melanoma in 19 patients (19.8%). Patients had a mean age of 42.4 years (± 19.4). The mean ages in the groups with junctional nevi and melanoma were 33.3 (± 19.5) and 51.9 (± 17.8), respectively; their difference was statistically significant (P value = 0.001). Hutchinson’s sign was present in 10 patients, 9 of which had melanoma. Also, melanoma was only observed in patients presenting with a solitary nail lesion. Nails mostly affected by melanoma were middle fingers of the hands (7 patients) and thumbs (6 patients). Out of 18 patients with nail dystrophy, 13 (72.2%) were diagnosed with melanoma.LimitationsOnly patients who have undergone biopsy were studied.ConclusionMelanoma is an important cause of LM in Iranian patients and should especially be suspected in older patients who present with a solitary nail lesion on their middle finger or thumb. Other findings that direct us toward melanoma are presence of Hutchinson’s sign and nail dystrophy.

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“…Lentigo accounts for 9% of single digit LM in adults and for 30% in children. 4,5 Melanoma was observed in 6% of single digit LM in adult 6 and is extremely rare in children. [7][8][9] When dealing with nail melanocytic lesions, 2 points should be taken into account: (1) The number of melanocytes is much lower in the nail than in the skin: about 200 per square millimeter in the nail matrix and absent to 50 per square millimeter in the nail bed compared with about 1150 per square millimeter in the epidermis.…”

Section: Introductionmentioning

confidence: 99%

Immunohistochemical Study of 40 Cases of Longitudinal Melanonychia

Theunis¹,

Richert²,

Saß³

et al. 2011

The American Journal of Dermatopathology

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The etiology of longitudinal melanonychia (LM) is difficult to establish by clinical and dermoscopic examinations alone. Microscopic examination of the nail matrix remains crucial. Two groups of LM may be identified: melanocytic activation (melanic pigmentation of the matrix epithelium without any increase in the density of melanocytes) and melanocytic proliferation (lentigo, nevus, or melanoma). The histological examination is challenging, and immunohistochemical investigations can be helpful. The objective of this study was to analyze the immunohistochemical findings with routinely used markers in melanocytic tumors-S-100 protein, HMB-45, and Melan-A-in LM. A series of 40 cases were analyzed: 10 activations, 4 lentigines, 7 nevi, 12 in situ melanomas, and 7 invasive melanomas. The sensitivity of S-100 protein is weak in benign and malignant intraepithelial melanocytes of the nail matrix, and if this marker is performed alone, it may be wrongly reassuring. However, the use of S-100 protein is essential to differentiate invasive melanoma, lacking an intraepithelial component, and particularly desmoplastic melanoma, from epithelial and mesenchymal tumors. HMB-45 and Melan-A are more sensitive than S-100 protein for the evaluation of intraepithelial melanocytic proliferation of the nail apparatus, with HMB-45 being the most intense marker. In the dermal component, HMB-45 and Melan-A were less sensitive than S-100 protein. In conclusion, we recommend that the panel of antibodies used for histological evaluation of LM should include HMB-45 and/or Melan-A and S-100 protein only if an invasive melanoma is suspected.

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Melanonychia, melanocytic hyperplasia, and nail melanoma in a Hispanic population

Cited by 39 publications

References 17 publications

Longitudinal Melanonychia: Differences in Etiology Are Associated with Patient Age at Diagnosis

Longitudinal Melanonychia: Differences in Etiology Are Associated with Patient Age at Diagnosis

Longitudinal melanonychia in an Iranian population: a study of 96 patients

Immunohistochemical Study of 40 Cases of Longitudinal Melanonychia

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