An Evidence-Based Approach to Pediatric Melanonychia

Mary E Lohman; Timothy H McCalmont; Kelly M Cordoro

doi:10.1016/j.det.2021.09.004

An Evidence-Based Approach to Pediatric Melanonychia

Dermatol Clin. 2022 Jan;40(1):37-49. doi: 10.1016/j.det.2021.09.004. Epub 2021 Oct 22.

Authors

Mary E Lohman¹, Timothy H McCalmont², Kelly M Cordoro³

Affiliations

¹ Department of Dermatology, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA.
² Department of Dermatology and Department of Pathology, University of California, San Francisco, 1701 Divisadero Street, Second Floor, San Francisco, CA 94115.
³ Pediatric Dermatology, Department of Dermatology, University of California, San Francisco, 1701 Divisadero Street, Third Floor, San Francisco, CA 94115, USA. Electronic address: [email protected].

PMID: 34799034
DOI: 10.1016/j.det.2021.09.004

Abstract

Melanonychia including melanonychia striata in children poses a diagnostic dilemma. Atypical clinical features often raise the possibility of malignancy, and a nail unit biopsy may be recommended. Commensurate with atypical clinical features, the histopathology may also appear alarming. However, accumulating data illustrate that most cases of melanonychia striata are benign and suggest that an alternate approach is often warranted for pediatric patients. Herein, we review the existing data regarding pediatric melanonychia striata and offer an evidence-based approach to its evaluation and management.

Keywords: Children; Melanoma; Melanonychia; Nevus; Pediatric; Pigmented lesions.

Publication types

Review

MeSH terms

Child
Humans
Melanoma* / diagnosis
Nail Diseases* / diagnosis
Nail Diseases* / therapy
Nails
Nevus, Pigmented*
Skin Neoplasms* / diagnosis