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Clinical and dermoscopic clues to differentiate pigmented nail bands: an International Dermoscopy Society study
Author(s) -
Benati E.,
Ribero S.,
Longo C.,
Piana S.,
Puig S.,
Carrera C.,
Cicero F.,
Kittler H.,
Deinlein T.,
Zalaudek I.,
Stolz W.,
Scope A.,
Pellacani G.,
Moscarella E.,
Piraccini B.M.,
Starace M.,
Argenziano G.
Publication year - 2017
Publication title -
journal of the european academy of dermatology and venereology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.655
H-Index - 107
eISSN - 1468-3083
pISSN - 0926-9959
DOI - 10.1111/jdv.13991
Subject(s) - medicine , nail (fastener) , dermatology , melanoma , acral lentiginous melanoma , nail plate , multivariate analysis , retrospective cohort study , pathology , psoriasis , materials science , cancer research , metallurgy
Background Longitudinal melanonychia might be difficult to differentiate and the use of dermoscopy can be useful for the preoperative evaluation and management decision. Objectives The aim of our study was to investigate clinical and dermoscopic criteria of acquired longitudinal melanonychia in adults to identify the best predictors of melanoma using a multivariate analysis and to explore eventual new dermoscopic criteria for nail melanoma diagnosis. Methods In this retrospective observational study, 82 histopathologically diagnosed, acquired nail pigmented bands were collected and examined. All variables were included in the analysis and examined as possible predictors of nail melanoma. Both univariate and multivariable analyses have been performed. Results Among 82 cases, 25 were diagnosed as nail melanoma and 57 as benign lesions (including 32 melanocytic nevi and 25 benign melanocytic hyperplasia). Melanoma cases were significantly associated with a width of the pigmented band higher than 2/3 of the nail plate, grey and black colours, irregularly pigmented lines, Hutchinson and micro‐Hutchinson signs, and nail dystrophy. Granular pigmentation, a newly defined dermoscopic criterion, was found in 40% of melanomas and only in 3.51% of benign lesions. Conclusions Dermoscopic examination of longitudinal melanonychia provides useful information that could help clinicians to improve melanoma recognition.