Nails

Melanonychia Striata

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Melanonychia Striata, Longitudinal Melanonychia, Longitudinal Brown Stripes in Nail, Hyperpigmented Vertical Nail Bands

  • See Also
  1. Nail Longitudinal Band
  • Epidemiology
  1. Normal variant in 90% of black patients
  2. Uncommon in lighter skinned patients
  • Signs
  1. Hyperpigmented longitudinal band (brown, black or tan coloration)
  2. Nonblanchable
  3. Typically spans the entire length of nail
  4. May affect one or multiple nails
  • Risk Factors
  1. Most common in black patients
  2. See Hyperpigmentation
  • Differential Diagnosis
  1. See Melanonychia
  2. See Nail Longitudinal Band
  3. Nail Splinter Hemorrhage
    1. Do not span the entire longitudinal length of the nail bed
  4. Subungual Melanoma (50% of Melanomas in dark skinned patients)
    1. Critical to distinguish from the benign vertical nail bands
    2. Most commonly affects the great toe or thumb
    3. Bands are typically wider than 3 mm
  • Evaluation
  1. Biopsy suspicious Longitudinal Melanonychia
  • References
  1. Tully (2012) Am Fam Physician 85(8): 779-87 [PubMed]