Novel Insights from Clinical Practice

Andrade L.F.a· Mashoudy K.D.a· Morrison B.b· Tosti A.b

Author affiliations

aUniversity of Miami Miller School of Medicine, Miami, FL, USA
bDepartment of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, FL, USA

Log in to MyKarger to check if you already have access to this content.

Buy FullText & PDF Unlimited re-access via MyKarger Unrestricted printing, no saving restrictions for personal use read more

CHF 38.00 *
EUR 35.00 *
USD 39.00 *

Select

KAB

Buy a Karger Article Bundle (KAB) and profit from a discount!

If you would like to redeem your KAB credit, please log in.

Save over 20% compared to the individual article price.

Learn more

Rent via DeepDyve Unlimited fulltext viewing of this article Organize, annotate and mark up articles Printing and downloading restrictions apply

Start free trial

Subscribe Access to all articles of the subscribed year(s) guaranteed for 5 years Unlimited re-access via Subscriber Login or MyKarger Unrestricted printing, no saving restrictions for personal use read more

Subcription rates

Select

* The final prices may differ from the prices shown due to specifics of VAT rules.

Article / Publication Details

First-Page Preview

Received: November 09, 2022
Accepted: January 20, 2023
Published online: March 22, 2023

Number of Print Pages: 6
Number of Figures: 2
Number of Tables: 2

ISSN: 2296-9195 (Print)
eISSN: 2296-9160 (Online)

For additional information: https://www.karger.com/SAD

Abstract

Introduction: Longitudinal melanonychia, a pigmented longitudinal streak on the nail, is a common clinical finding that may be associated with subungual melanoma with varying presentation depending on race and skin tone. It has been long reported that darker skinned ethnicities have a higher prevalence of longitudinal melanonychia in the US population (e.g., African Americans with 77% prevalence) [Indian J Dermatol. 2021;66(4):445], but unfortunately, there are limited studies exclusively looking at longitudinal melanonychia in pediatric patients of color. Case Presentation: In this case series, we review the current literature and report the findings of 8 cases of longitudinal melanonychia in children with skin types IV or greater. Out of the 8 cases identified, only 4 returned to the clinic for monitoring (n = 4), and there was an average of 20.8 months between the initial and final visits. Of the patients that returned for follow-up, 2 showed no relevant changes in the nail pigmentation, 1 showed fading of the band, and 1 patient showed enlargement of the band to involve the whole nail. Conclusion: Although many sources recommend a conservative approach to treatment that involves monitoring and follow-up, our findings indicate that a wait-and-see method cannot be applied to all cases in the pediatric population due to disruptions in continuity of care. An individualized approach considering such factors should be employed for each patient, and certain high-risk features of the ABCDEF nail melanoma model may be relevant in pediatric cases.

© 2023 S. Karger AG, Basel

References Bellet JS. Nail discoloration in pediatric skin of color patients. Pediatr Dermatol. 2021 Nov;38(Suppl 2):37–41. Lee JH, Lim Y, Park JH, Lee JH, Jang KT, Kwon EJ, et al. Clinicopathologic features of 28 cases of nail matrix nevi (NMNs) in Asians: comparison between children and adults. J Am Acad Dermatol. 2018 Mar;78(3):479–89. Lee JS, Kim S, Kim DH, Lee JW, Mun JH, Lee SH. Clinical features and natural course of pediatric longitudinal melanonychia: a retrospective cohort study in Korea. J Am Acad Dermatol. 2022 Aug;87(2):366–72. Ansari MS, Mahmoudi H, Sadeghinia A, Azizzadeh-Roodpishi S, Ghanadan A, Daneshpazhooh M. Dermoscopic evaluation of longitudinal melanonychia in children: a prospective study. Indian J Dermatol. 2021;66(4):445. Maddy AJ, Tosti A. Spontaneous regression of a nail matrix melanocytic nevus in a child. Pediatr Dermatol. 2017 Sep;34(5):e254–6. Lee J, Bae J, Lee D. Melanocytic nevi on the hyponychium with dermoscopic features of longitudinal brush pigmentation in children. Pediatr Dermatol. 2021 Sep;38(5):1264–6. Lee J, Park S, Lee D, Jang KT, Kwon EJ. Longitudinal brush pigmentation on the hyponychium, a dermoscopic feature observed in pediatric nail matrix nevi. J Am Acad Dermatol. 2021 Jun;84(6):1758–60. Ohn J, Choe YS, Mun JH. Dermoscopic features of nail matrix nevus (NMN) in adults and children: a comparative analysis. J Am Acad Dermatol. 2016 Sep;75(3):535–40. Astur Md MM, Farkas CB, Junqueira JP, Enokihara MMSES, Enokihara MY, Michalany N, et al. Reassessing melanonychia striata in phototypes IV, V, and VI patients. Dermatol Surg. 2016 Feb;42(2):183–90. Leyden JJ, Spott DA, Goldschmidt H. Diffuse and banded melanin pigmentation in nails. Arch Dermatol. 1972 Apr;105(4):548–50. Lee MK, Seo SB, Jung JY, Shin YS, Cho EB, Park EJ, et al. Longitudinal melanonychia in childhood: a clinical and histopathological review of Korean patients. Eur J Dermatol. 2017 Jun 1;27(3):275–80. Colin Tan W, Wang DY, Seghers AC, Koh MJA, Nicholas Goh SG, Joyce Lee SS. Should we biopsy melanonychia striata in Asian children? A retrospective observational study. Pediatr Dermatol. 2019 Nov;36(6):864–8. Leung AKC, Robson WLM, Liu EKH, Kao CP, Fong JHS, Leong AG, et al. Melanonychia striata in Chinese children and adults. Int J Dermatol. 2007 Sep;46(9):920–2. Cooper C, Arva NC, Lee C, Yélamos O, Obregon R, Sholl LM, et al. A clinical, histopathologic, and outcome study of melanonychia striata in childhood. J Am Acad Dermatol. 2015 May;72(5):773–9. Tseng YT, Liang CW, Liau JY, Chang K, Tseng YH, Chen JS, et al. Longitudinal melanonychia: differences in etiology are associated with patient age at diagnosis. Dermatology. 2017;233(6):446–55. Antonovich DD, Grin C, Grant-Kels JM. Childhood subungual melanoma in situ in diffuse nail melanosis beginning as expanding longitudinal melanonychia. Pediatr Dermatol. 2005 May–Jun;22(3):210–2. Taniguchi K, Kaku Y, Fukuda M, Fujisawa A, Tanioka M, Dainichi T, et al. Ten-year follow up of longitudinal melanonychia in childhood: a case report. J Dermatol. 2019 Mar;46(3):e89–90. Iorizzo M, Tosti A, Di Chiacchio N, Hirata SH, Misciali C, Michalany N, et al. Nail melanoma in children: differential diagnosis and management. Dermatol Surg. 2008 Jul;34(7):974–8. Heymann WR. Pediatric longitudinal melanonychia: delaying the bottom line. J Am Acad Dermatol. 2022 Aug;87(2):296–7. Matsui Y, Sasaki J, Takatsuka S, Takenouchi T. Natural course of pediatric longitudinal melanonychia: a retrospective cohort study in Japan. J Am Acad Dermatol. 2022 Apr;86(4):946–8. Koga H, Saida T, Uhara H. Key point in dermoscopic differentiation between early nail apparatus melanoma and benign longitudinal melanonychia. J Dermatol. 2011 Jan;38(1):45–52. Wilken R, Carucci J, Stevenson ML. Skin cancers and lung transplant. Semin Respir Crit Care Med. 2021;42(3):483–96. Coughlin CC, Pérez M, Kumar MG, Jeffe DB, Bayliss SJ, Sternhell-Blackwell K. Skin cancer risk education in pediatric solid organ transplant patients: an evaluation of knowledge, behavior, and perceptions over time. Pediatr Transplant. 2017;21(2):e12817. Ko D, Oromendia C, Scher R, Lipner SR. Retrospective single-center study evaluating clinical and dermoscopic features of longitudinal melanonychia, ABCDEF criteria, and risk of malignancy. J Am Acad Dermatol. 2019;80(15):1272–83. Article / Publication Details

First-Page Preview

Received: November 09, 2022
Accepted: January 20, 2023
Published online: March 22, 2023

Number of Print Pages: 6
Number of Figures: 2
Number of Tables: 2

ISSN: 2296-9195 (Print)
eISSN: 2296-9160 (Online)

For additional information: https://www.karger.com/SAD

Copyright / Drug Dosage / Disclaimer Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.