melanonychia striata

melanonychia striata

A descriptive term for the presence of a longitudinal dark stripe arising in the lunula of a (finger- or toe-) nail bed, and extending to the distal end of the nail in the axis of normal nail growth.

Single melanonychia striata
▪ Neoplastic
   – Melanocytic;
   – Melanoma;
   – Melanocytic hyperplasia;
   – Nevus.
▪ Nonmelanocytic
   – Bowen's disease;
   – Myxoid cyst;
   – Wart.

Pseudo-Melanonychia Striata
▪ Haemorrhage
▪ Foreign body
▪ Onychomycosis

Multiple melanonychia striata
▪ Drugs and chemical:
   – Antibiotics: cyclines, sulfonamide;
   – Antimalarials;
   – Beta blockers;
   – Chemotherapy;
   – Heavy metals: arsenic, gold, mercury;
   – Ketoconazole;
   – Phenothiazine;
   – Psoralen;
   – Zidovudine;
▪ Endocrine:
   – Corticotropin therapy;
   – Corticotropin-producing tumours;
   – Melanocyte-stimulating hormone;
   – Addison's disease;
   – Hyperthyroidism;
   – Pregnancy.
▪ Genetic and Ethnic:
   – Dark-pigmented persons;
   – Peutz-Jeghers syndrome.
▪ Infection and Inflammation:
   – Onychomycosis;
   – Lichen planus;
   – Lichen striatus.
▪ Metabolic and Nutritional:
   – Haemochromatosis;
   – Haemosiderosis;
   – Kwashiorkor;
   – Vitamin B12 deficiency.
▪ Miscellaneous:
   – Laugier-Hunziker syndrome;
   – Carpal tunnel syndrome;
   – Radiation;
   – Trauma;
   – Self-inflicted, onychomania.
References in periodicals archive ?
Beau's lines seen in 4%, onychodystrophy seen in 2%, melanonychia striata in 8%
The only way to definitively rule out melanoma in a case of melanonychia striata is to perform a biopsy of the nail matrix, according to Dr.
Some recent articles in the medical literature suggest that if cases of melanonychia striata in childhood are stable and not atypical in appearance, observation may be an option.
Every case of melanonychia striata must be evaluated individually, Dr.
Melanonychia striata affect about 1% of whites and 11% of Japanese individuals.
The probability of melanonychia striata in children is far lower than it is in adults, comprising just 1%-4% of all melanomas in individuals less than 20 years of age.
The 2 most important signs of subungual melanoma are melanonychia striata (longitudinal brown to black pigmented streaks in the nail) and Hutchinson's sign, which is the spread of brown or black pigment from the nail bed, nail matrix, or nail plate onto the adjacent cuticle or onto the proximal or the lateral nail fold.
The differential diagnosis of melanonychia striata is quite long, and most of these streaks are benign (TABLE 2).
A debate has recently arisen in the literature regarding the approach to melanonychia striata in children, for whom the probability of melanoma is far lower than in adults.
The new thinking is that because most melanonychia striata in children are nevi and not melanoma, observation during childhood is an option as long as the lesions are stable and not atypical in appearance.
SAN DIEGO -- A longitudinal pigmented streak beneath the nail could either be a benign melanonychia striata or a far-from-benign subungual melanoma, but despite the vast difference in prognosis, the two conditions are very difficult to tell apart clinically, Dr.
Furthermore, melanonychia striata can sometimes be an early sign of melanoma, she noted.