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Melanonychia - Longitudinal Melanonychia - Melanonychia Striata And Treatment of Melanonychia

Longitudinal melanonychia is the presence of a pigmented stripe, usually brown or black, along the length of the nail bed in darker-skinned individuals. Longitudinal melanonychia results from deposition of melanin in the nail plate from a variety of causes. A small number of people with longitudinal melanonychia have subungual melanoma.

Longitudinal melanonychia associated with scleroderma is rare. This is paradoxical, as increased skin pigmentation is frequent in the latter disease.

A number of conditions can cause longitudinal melanonychia, but its main importance is that, in some patients, it may indicate the presence of a subungual malignant melanoma. Hyperpigmented nail bands are not uncommon in African-American, Latino and Asian patients, especially those over sixty years of age, and are often multiple in these groups. Longitudinal melanonychia is most worrisome when there is a solitary, dark, broad longitudinal band with pigment extending over the proximal nail fold (Hutchinson’s sign). Such findings are considered to be a strong indication for biopsy of the nail matrix to rule out melanoma.

Symptoms of Melanonychia

Some common symptoms of Melanonychia are :-

• Discoloration of nail may occur.
• Yellowing, thickening or crumbling of the nail.
• Pain may occur in the nail.

Treatment of Longitudinal Melanonychia

In the treatment of Melanonychia (Longitudinal Melanonychia), the hyperpigmentation of the skin and nails induced by chemotherapy is reversible and most commonly seen with drugs like doxorubicin, cyclophosphamide and hydroxyurea. Patients should be educated about the use of appropriate footwear, especially in high-exposure areas, such as communal bathing facilities and health clubs. Prophylactic antifungal therapy may be required to prevent reinfection of the skin and the nails