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When all you have is a dermatoscope- start looking at the nails.

Haenssle HA, Blum A, Hofmann-Wellenhof R, Kreusch J, Stolz W, Argenziano G, Zalaudek I, Brehmer F - Dermatol Pract Concept (2014)

Bottom Line: The formation of continuous, longitudinal pigmented streaks (longitudinal melanonychia) may either be caused by a benign activation of matrix melanocytes (e.g., as a result of trauma, inflammation, or adverse drug reactions) or by a true melanocytic proliferation (e.g., in a nevus or melanoma).Important and common differential diagnoses in these cases are subungual hemorrhage or onychomycosis.Benign or malignant neoplasms that may also affect the nail unit include glomus tumor, Bowen's disease, squamous cell carcinoma, and rare collision tumors.

View Article: PubMed Central - PubMed

Affiliation: Department of Dermatology, Venereology and Allergology, University Medical Center Göttingen, Göttingen, Germany ; Department of Dermatology, Venereology and Allergology, University Medical Center Heidelberg, Heidelberg, Germany.

ABSTRACT
Pigmented and non-pigmented nail alterations are a frequent challenge for dermatologists. A profound knowledge of clinical and dermatoscopic features of nail disorders is crucial because a range of differential diagnoses and even potentially life-threatening diseases are possible underlying causes. Nail matrix melanocytes of unaffected individuals are in a dormant state, and, therefore, fingernails and toenails physiologically are non-pigmented. The formation of continuous, longitudinal pigmented streaks (longitudinal melanonychia) may either be caused by a benign activation of matrix melanocytes (e.g., as a result of trauma, inflammation, or adverse drug reactions) or by a true melanocytic proliferation (e.g., in a nevus or melanoma). In general, non-continuous nail alterations, affecting only limited parts of the nail apparatus, are most frequently of non-melanocytic origin. Important and common differential diagnoses in these cases are subungual hemorrhage or onychomycosis. In addition, foreign bodies, bacterial infections, traumatic injuries, or artificial discolorations of the nail unit may less frequently cause non-continuous nail alterations. Many systemic diseases that may also show involvement of the nails (e.g., psoriasis, atopic dermatitis, lichen planus, alopecia areata) tend to induce alterations in numerous if not all nails of the hands and feet. A similar extensive and generalized alteration of nails has been reported after treatment with a number of systemic drugs, especially antibiotics and cytostatics. Benign or malignant neoplasms that may also affect the nail unit include glomus tumor, Bowen's disease, squamous cell carcinoma, and rare collision tumors. This review aims to assist clinicians in correctly evaluating and diagnosing nail disorders with the help of dermatoscopy.

No MeSH data available.


Related in: MedlinePlus

Onychopapilloma. (A–B) Overview. (C–D) Dermatoscopy. Longitudinal erythronychia that does not continuously involve the whole nail but that leaves an unaffected interval at the proximal nail matrix. Few reddish-black streaks represent hemorrhages and serous inclusions with yellowish background pigmentation. Dermatoscopy of the distal nail margin reveals the typical rough verrucous surface of a wedge-shaped notch with red-black dots. (Copyright: ©2014 Haenssle et al.)
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f6-dp0404a02: Onychopapilloma. (A–B) Overview. (C–D) Dermatoscopy. Longitudinal erythronychia that does not continuously involve the whole nail but that leaves an unaffected interval at the proximal nail matrix. Few reddish-black streaks represent hemorrhages and serous inclusions with yellowish background pigmentation. Dermatoscopy of the distal nail margin reveals the typical rough verrucous surface of a wedge-shaped notch with red-black dots. (Copyright: ©2014 Haenssle et al.)

Mentions: Onychopapilloma is a benign neoplasms, that originates from the distal nail matrix and/or the nail bed [11,12]. It typically presents with longitudinal leukonychia or longitudinal erythronychia that does not continuously involve the whole nail, but that leaves an unaffected interval at the proximal nail matrix. Importantly, cases of onychopapilloma presenting as longitudinal melanonychia of grayish color have been reported [13]. The dermatoscopic view from the free distal margin of the nail plate typically reveals a wedge-shaped hyperkeratotic notch (Figure 6A–D).


When all you have is a dermatoscope- start looking at the nails.

Haenssle HA, Blum A, Hofmann-Wellenhof R, Kreusch J, Stolz W, Argenziano G, Zalaudek I, Brehmer F - Dermatol Pract Concept (2014)

Onychopapilloma. (A–B) Overview. (C–D) Dermatoscopy. Longitudinal erythronychia that does not continuously involve the whole nail but that leaves an unaffected interval at the proximal nail matrix. Few reddish-black streaks represent hemorrhages and serous inclusions with yellowish background pigmentation. Dermatoscopy of the distal nail margin reveals the typical rough verrucous surface of a wedge-shaped notch with red-black dots. (Copyright: ©2014 Haenssle et al.)
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4230252&req=5

f6-dp0404a02: Onychopapilloma. (A–B) Overview. (C–D) Dermatoscopy. Longitudinal erythronychia that does not continuously involve the whole nail but that leaves an unaffected interval at the proximal nail matrix. Few reddish-black streaks represent hemorrhages and serous inclusions with yellowish background pigmentation. Dermatoscopy of the distal nail margin reveals the typical rough verrucous surface of a wedge-shaped notch with red-black dots. (Copyright: ©2014 Haenssle et al.)
Mentions: Onychopapilloma is a benign neoplasms, that originates from the distal nail matrix and/or the nail bed [11,12]. It typically presents with longitudinal leukonychia or longitudinal erythronychia that does not continuously involve the whole nail, but that leaves an unaffected interval at the proximal nail matrix. Importantly, cases of onychopapilloma presenting as longitudinal melanonychia of grayish color have been reported [13]. The dermatoscopic view from the free distal margin of the nail plate typically reveals a wedge-shaped hyperkeratotic notch (Figure 6A–D).

Bottom Line: The formation of continuous, longitudinal pigmented streaks (longitudinal melanonychia) may either be caused by a benign activation of matrix melanocytes (e.g., as a result of trauma, inflammation, or adverse drug reactions) or by a true melanocytic proliferation (e.g., in a nevus or melanoma).Important and common differential diagnoses in these cases are subungual hemorrhage or onychomycosis.Benign or malignant neoplasms that may also affect the nail unit include glomus tumor, Bowen's disease, squamous cell carcinoma, and rare collision tumors.

View Article: PubMed Central - PubMed

Affiliation: Department of Dermatology, Venereology and Allergology, University Medical Center Göttingen, Göttingen, Germany ; Department of Dermatology, Venereology and Allergology, University Medical Center Heidelberg, Heidelberg, Germany.

ABSTRACT
Pigmented and non-pigmented nail alterations are a frequent challenge for dermatologists. A profound knowledge of clinical and dermatoscopic features of nail disorders is crucial because a range of differential diagnoses and even potentially life-threatening diseases are possible underlying causes. Nail matrix melanocytes of unaffected individuals are in a dormant state, and, therefore, fingernails and toenails physiologically are non-pigmented. The formation of continuous, longitudinal pigmented streaks (longitudinal melanonychia) may either be caused by a benign activation of matrix melanocytes (e.g., as a result of trauma, inflammation, or adverse drug reactions) or by a true melanocytic proliferation (e.g., in a nevus or melanoma). In general, non-continuous nail alterations, affecting only limited parts of the nail apparatus, are most frequently of non-melanocytic origin. Important and common differential diagnoses in these cases are subungual hemorrhage or onychomycosis. In addition, foreign bodies, bacterial infections, traumatic injuries, or artificial discolorations of the nail unit may less frequently cause non-continuous nail alterations. Many systemic diseases that may also show involvement of the nails (e.g., psoriasis, atopic dermatitis, lichen planus, alopecia areata) tend to induce alterations in numerous if not all nails of the hands and feet. A similar extensive and generalized alteration of nails has been reported after treatment with a number of systemic drugs, especially antibiotics and cytostatics. Benign or malignant neoplasms that may also affect the nail unit include glomus tumor, Bowen's disease, squamous cell carcinoma, and rare collision tumors. This review aims to assist clinicians in correctly evaluating and diagnosing nail disorders with the help of dermatoscopy.

No MeSH data available.


Related in: MedlinePlus