Publication: Clinical and onychoscopic features of benign and malignant conditions in longitudinal melanonychia in the thai population: A comparative analysis
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Issued Date
2020
Resource Type
File Type
application/pdf
ISSN
11787015
Other identifier(s)
2-s2.0-85096398361
Rights Holder(s)
Scopus
Bibliographic Citation
Clinical, Cosmetic and Investigational Dermatology. Vol 13, (2020), p.857-865
Suggested Citation
Kungvalpivat P., Rojhirunsakool S., Chayavichitsilp P., Suchonwanit P., Wichayachakorn C.T., Rutnin S. Clinical and onychoscopic features of benign and malignant conditions in longitudinal melanonychia in the thai population: A comparative analysis. Clinical, Cosmetic and Investigational Dermatology. Vol 13, (2020), p.857-865. doi:10.2147/CCID.S283112 Retrieved from: https://hdl.handle.net/20.500.14740/4937
Abstract
Background: Longitudinal melanonychia can arise from many underlying conditions, both benign and malignant. Practitioners tend to be reluctant to perform a biopsy of this condition due to procedure-related pain and the possibility of permanent nail dystrophy. Onychoscopy has become a useful tool to provide a provisional diagnosis and assist in deciding on a nail biopsy. Objective: To investigate and differentiate the clinical and onychoscopic features of sub-ungual melanoma (SUM)/subungual melanoma in situ (SMIS) and other benign melanocytic conditions (BM). Materials and Methods: In this cross-sectional study, a total of 32 cases of longitudinal melanonychia were examined, and baseline characteristics were recorded. Onychoscopic pictures were taken by handheld dermoscopy with 10x and 50x magnification. A biopsy was then performed in each case, and a pathological diagnosis was obtained. Results: Of the 32 cases, 6 were diagnosed with SMIS and 26 with BM (21 simple lentigines, 5 junctional nevi). The median age was significantly higher among the SMIS group (56 vs 31 years) (p = 0.034). Regarding onychoscopic findings, cases with SMIS were significantly associated with a greater band width percentage (p = 0.014), multicolor presentation (p = 0.005), the presence of granular pigmentation (p = 0.034), and micro-Hutchinson’s sign (p = 0.015). In addition, subungual hyperkeratosis, a newly recognized onychoscopic feature, was more significantly associated with SMIS in comparison to BM (p = 0.002). Conclusion: Onychoscopy provides useful information to aid in the differential diagnosis of longitudinal melanonychia. From our study, onychoscopy can be utilized to assist in making a decision whether to perform a biopsy in patients with longitudinal melanonychia suspicious of malignant melanocytic conditions. © 2020 Kungvalpivat et al.