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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

Ethnic lentigo of the right great toenail. (A) Overview. (B) Dermatoscopy. Dermatoscopically there is a homogeneous gray-ish-pale longitudinal melanonychia affecting the whole nail with a slightly diffuse demarcation of the lateral margin. (Copyright: ©2014 Haenssle et al.; first published in Der Hautarzt, 2014, 65(4):301–11.)
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f16-dp0404a02: Ethnic lentigo of the right great toenail. (A) Overview. (B) Dermatoscopy. Dermatoscopically there is a homogeneous gray-ish-pale longitudinal melanonychia affecting the whole nail with a slightly diffuse demarcation of the lateral margin. (Copyright: ©2014 Haenssle et al.; first published in Der Hautarzt, 2014, 65(4):301–11.)

Mentions: The ethnic subungual lentigo predominantly occurs in humans with a darker skin type categorized according to Fitzpatrick skin classification (e.g., Indian skin type, skin type V). Multiple nails are frequently affected and the color is homogeneous gray-brown. The thin longitudinal lines that might be discriminated within the pigmented band are regular in their coloration, thickness and spacing (Figure 16A, B) [7,8]. The lateral margin of pigmentation is often diffuse. Occasionally, the pigmented band of a subungual ethical lentigo is very subtle and pale and therefore may be difficult to separate from the uninvolved nail-plate in a clinical-dermatoscopic examination.


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)

Ethnic lentigo of the right great toenail. (A) Overview. (B) Dermatoscopy. Dermatoscopically there is a homogeneous gray-ish-pale longitudinal melanonychia affecting the whole nail with a slightly diffuse demarcation of the lateral margin. (Copyright: ©2014 Haenssle et al.; first published in Der Hautarzt, 2014, 65(4):301–11.)
© Copyright Policy
Related In: Results  -  Collection

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

f16-dp0404a02: Ethnic lentigo of the right great toenail. (A) Overview. (B) Dermatoscopy. Dermatoscopically there is a homogeneous gray-ish-pale longitudinal melanonychia affecting the whole nail with a slightly diffuse demarcation of the lateral margin. (Copyright: ©2014 Haenssle et al.; first published in Der Hautarzt, 2014, 65(4):301–11.)
Mentions: The ethnic subungual lentigo predominantly occurs in humans with a darker skin type categorized according to Fitzpatrick skin classification (e.g., Indian skin type, skin type V). Multiple nails are frequently affected and the color is homogeneous gray-brown. The thin longitudinal lines that might be discriminated within the pigmented band are regular in their coloration, thickness and spacing (Figure 16A, B) [7,8]. The lateral margin of pigmentation is often diffuse. Occasionally, the pigmented band of a subungual ethical lentigo is very subtle and pale and therefore may be difficult to separate from the uninvolved nail-plate in a clinical-dermatoscopic examination.

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