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The term melanonychia refers to a brownish pigmentation produced by melanocytes in matrix, which extends from the proximal region up until the distal margin of the nail plate. This condition occurs due to the activation or hyperplasia of melanocytes, which presents benign lesions, such as nevi and lentigo or malignant lesions, such as melanoma of the nail unit. The intraoperative dermoscopic analysis of the nail matrix improves the diagnostic accuracy and guides on the best biopsy method for melanonychia. A proper biopsy technique is aimed at obtaining a good quality sample for the histological diagnosis – the gold standard – associated with a lower risk of permanent dystrophy.

Intraoperative dermoscopy as a tool in the diagnosis of melanonychia: case report