• Eckart Haneke


The term melanonychia denotes a brown or black nail, not the pigment itself. There are many reasons for a brown nail, many different patterns of melanonychia (longitudinal, transverse, diffuse, etc.), and a number of diagnoses. Longitudinal melanonychia (LM) always derives from a focus of melanin-producing melanocytes in the matrix and is due to melanin incorporation into the growing nail. It is rare in light-skinned Caucasians and very common in dark-skinned individuals, particularly as they age. An acquired LM in a light-skinned person over 30-years is suspicious for ungual melanoma whereas most LMs in children and adolescents are due to a matrix lentigo or nevus. Most amelanotic nail melanomas derive from the nail bed, but even the extremely rare pigmented nail bed melanomas cannot produce an LM. Periungual pigmentation called Hutchinson’s sign, in association with an acquired LM is indicative of melanoma. Treatment of early subungual melanoma is by wide local excision of the entire nail organ with 6 mm around the anatomic border and 10 mm around Hutchinson’s sign. Advanced ungual melanoma still requires distal amputation. All brown and black nail pigmentations have to be considered in the differential diagnosis.


Brown nail Longitudinal melanonychia Melanocyte hyperfunction Nail nevus Nail lentigo Melanoma Treatment 

Supplementary material

978-3-319-65649-6_16_MOESM1_ESM.pdf (25 kb)
Patient Handout (PDF 25 kb)


  1. 1.
    Amin B, Nehal KS, Jungbluth AA, Zaidi B, Brady MS, Coit DC, Zhou Q, Busam KJ. Histologic distinction between subungual lentigo and melanoma. Am J Surg Pathol. 2008;32:835–43.PubMedGoogle Scholar
  2. 2.
    Tosti A, Piraccini BM, Cadore de Farias D. Dealing with melanonychia. Semin Cutan Med Surg. 2009;28:49–54.Google Scholar
  3. 3.
    Perrin C, Michiels JF, Pisani A, Ortonne JP. Anatomic distribution of melanocytes in normal nail unit: an immunohistochemical investigation. Am J Dermatopathol. 1997;19:462–7.PubMedPubMedCentralGoogle Scholar
  4. 4.
    De Berker D, Dawber RPR, Thody A, Graham A. Melanocytes are absent from normal nail bed; the basis of a clinical dictum. Br J Dermatol. 1996;134:564.Google Scholar
  5. 5.
    Kazi R, Moghaddam S, Chu P, Marghoob AA. Histologic evidence of melanocytes isolated to the nail matrix. JAMA Dermatol. 2016;152:573–5.PubMedPubMedCentralGoogle Scholar
  6. 6.
    Higashi N. Melanocytes of nail matrix and nail pigmentation. Arch Dermatol. 1968;97:570–4.PubMedPubMedCentralGoogle Scholar
  7. 7.
    Shukla VK, Hughes LE. How common are benign subungual naevi? Eur J Surg Oncol. 1992;18:249–50.PubMedGoogle Scholar
  8. 8.
    Duhard E, Calvet C, Mariotte N, Tichet J, Vaillant L. Prevalence of longitudinal melanonychia in the white population. Ann Dermatol Venereol. 1995;122:586–90.PubMedGoogle Scholar
  9. 9.
    Thomas L, Dalle S. Dermoscopy provides useful information for the management of melanonychia striata. Dermatol Ther. 2007;20:3–10.Google Scholar
  10. 10.
    Tosti A, Baran R, Piraccini BM, Cameli N, Fanti PA. Nail matrix nevi: a clinical and histopathologic study of twenty-two patients. J Am Acad Dermatol. 1996;34:765–71.PubMedGoogle Scholar
  11. 11.
    Naylor EM, Ruben BS, Robinson-Bostom L, Telang GH, Jellinek NJ. Subungual blue nevus with combined phenotypic features. J Am Acad Dermatol. 2008;58:1021–4.PubMedGoogle Scholar
  12. 12.
    Baran R. Frictional longitudinal melanonychia: a new entity. Dermatologica. 1987;174:280–4.PubMedGoogle Scholar
  13. 13.
    Baran R. Nail biting and picking as a possible cause of longitudinal melanonychia: a study of 6 cases. Dermatologica. 1990;181:126–8.PubMedGoogle Scholar
  14. 14.
    Anolik RB, Shah K, Rubin AI. Onychophagia-induced longitudinal melanonychia. Ped Dermatol. 2012;29:488–9.Google Scholar
  15. 15.
    Piraccini BM, Iorizzo M, Starace M, et al. Drug-induced nail diseases. Dermatol Clin. 2006;24:387–91.PubMedGoogle Scholar
  16. 16.
    Schepis C, Siragusa M, Palazzo R, Piraccini BM. Multiple melanonychia as a sign of pituitary adenoma. Clin Exp Dermatol. 2013;38:689–90.PubMedGoogle Scholar
  17. 17.
    Haneke E. Laugier-Hunziker-Baran-Syndrom. Hautarzt. 1991;42:512–5.PubMedGoogle Scholar
  18. 18.
    Roberts AHN. Subungual melanoma following a single injury. J Hand Surg. 1984;9B:328–30.Google Scholar
  19. 19.
    O’Toole EA, Stephens R, Young M, Tanner A, Barnes L. Subungual melanoma: a relation to direct injury? J Am Acad Dermatol. 1995;33:525–8.PubMedGoogle Scholar
  20. 20.
    Saccone PG, Rayan GM. Subungual malignant degeneration following chronic perionychial infection. Orthop Res. 1993;5:623–6.Google Scholar
  21. 21.
    Bormann G, Marsch WC, Haerting J, Helmbold P. Concomitant traumas influence prognosis in melanomas of the nail apparatus. Br J Dermatol. 2006;155:76–80.PubMedGoogle Scholar
  22. 22.
    Astur Mde M, Farkas CB, Junqueira JP, Enokihara MM, Enokihara MY, Michalany N, Hirata SH. Reassessing melanonychia striata in phototypes IV, V, and VI patients. Dermatol Surg. 2016;42:183–90.PubMedGoogle Scholar
  23. 23.
    Ronger S, Touzet S, Ligeron C, Balme B, Viallard AM, Barrut D, Colin C, Thomas L. Dermoscopic examination of nail pigmentation. Arch Dermatol. 2002;138:1327–33.Google Scholar
  24. 24.
    Koga H, Saida T, Uhara H. Key point in dermoscopic differentiation between early nail apparatus melanoma and benign longitudinal melanonychia. J Dermatol. 2011;38:45–52.PubMedGoogle Scholar
  25. 25.
    Hirata SH, Yamada S, Almeida FA, Almeida FA, Tomomori-Yamashita J, Enokihara MY, Paschoal FM, Enokihara MM, Outi CM, Michalany NS. Dermoscopy of the nail bed and matrix to assess melanonychia striata. J Am Acad Dermatol. 2005;53:884–6.PubMedGoogle Scholar
  26. 26.
    Hirata SH, Yamada S, Almeida FA, Enokihara MY, Rosa IP, Enokihara MM, Michalany NS. Dermoscopic examination of the nail bed and matrix. Int J Dermatol. 2006;45:28–30.PubMedGoogle Scholar
  27. 27.
    Di Chiacchio N, Hirata SH, Enokihara MY, Michalany MS, Fabbrocini G, Tosti A. Dermatologists’ accuracy in early diagnosis of melanoma oft he nail matrix. Arch Dermatol. 2010;146:382–7.PubMedGoogle Scholar
  28. 28.
    Göktay F, Güneş P, Yaşar Ş, Güder H, Aytekin S. New observations of intraoperative dermoscopic features of the nail matrix and bed in longitudinal melanonychia. Int J Dermatol. 2015;54:1157–62.PubMedGoogle Scholar
  29. 29.
    Koga H, Yoshikawa S, Sekiguchi A, Fujii J, Saida T, Sota T. Automated evaluation system of dermoscopic images of longitudinal melanonychia: proposition of a discrimination index for detecting early nail apparatus melanoma. J Dermatol. 2014;41:867–71.PubMedGoogle Scholar
  30. 30.
    Tanaka M. Approach to the pigmented nail. 23rd Reg Dermatol Conf South-East Asia, Singapore, 21–24 April 2016.Google Scholar
  31. 31.
    Debarbieux S, Hospod V, Depaepe L, Balme B, Poulalhon N, Thomas L. Perioperative confocal microscopy of the nail matrix in the management of in situ or minimally invasive subungual melanomas. Br J Dermatol. 2012;167:828–36.PubMedGoogle Scholar
  32. 32.
    Levit EK, Kagen MH, Scher RK, Grossman M, Altman E. The ABC rule for clinical detection of subungual melanoma. J Am Acad Dermatol. 2000;42:269–74.Google Scholar
  33. 33.
    Sawada M, Yokota K, Matsumoto T, Shibata S, Yasue S, Sakakibara A, Kono M, Akiyama M. Proposed classification of longitudinal melanonychia based on clinical and dermoscopic criteria. Int J Dermatol. 2014;53:581–5.Google Scholar
  34. 34.
    Moulonguet I, Goettmann-Bonvallot S. Mélanonychies longitudinales. Ann Dermatol Vénéréol. 2016;143:53–60.PubMedGoogle Scholar
  35. 35.
    Daniel RC III, Zaias N. Pigmentary abnormalities of the nails with emphasis on systemic diseases. Dermatol Clin. 1988;6:305–13.PubMedGoogle Scholar
  36. 36.
    Baran R, Kechijian P. Longitudinal melanonychia (melanonychia striata): diagnosis and management. J Am Acad Dermatol. 1989;21:1165–17.PubMedGoogle Scholar
  37. 37.
    Duhard E, Calvet C, Mariotte N, Tichet J, Vaillant L. Prévalence des mélanonychies longitudinales chez le sujet blanc. Ann Dermatol Venereol. 1999;126:586–90.Google Scholar
  38. 38.
    Brescoll J, Daveluy S. A review of vitamin B12 in dermatology. Am J Clin Dermatol. 2015;16:27–33.PubMedGoogle Scholar
  39. 39.
    Clerico R, Corsetti P, Ambrifi M, Paolino G, Rossi MR, Bottoni U, Calvieri S. Longitudinal melanonychia in a patient with essential thrombocytosis under treatment with hydroxyurea. Acta Dermatovenerol Croat. 2012;20:281–3.Google Scholar
  40. 40.
    Sladden MJ, Mortimer NJ, Osborne JE. Longitudinal melanonychia and pseudo-Hutchinson sign associated with amlodipine. Br J Dermatol. 2005;153:219–20.PubMedGoogle Scholar
  41. 41.
    Parkins GJ, Burden AD, Makrygeorgou A. Psoralen ultraviolet A-induced melanonychia. Clin Exp Dermatol. 2015;40:331–2.PubMedGoogle Scholar
  42. 42.
    Paurobally D, El Hayderi L, Richert B, André J, Nikkels AF. Melanotan-associated transverse melanonychia. J Eur Acad Dermatol Venereol. 2013;27:128–9.PubMedGoogle Scholar
  43. 43.
    Sherman S, Karniel E. Longitudinal melanonychia in an African patient with acquired immunodeficiency syndrome (AIDS). Isr Med Assoc J. 2015;17:326–7.PubMedGoogle Scholar
  44. 44.
    Goettmann-Bonvallot S, André J, Bélaich S. Longitudinal melanonychia in children: a clinical and histopathologic study of 40 cases. J Am Acad Dermatol. 1999;41:17–22.PubMedGoogle Scholar
  45. 45.
    Tan KB, Moncrieff M, Thompson JF, McCarthy SW, Shaw HM, Quinn MJ, Li LX, Crotty KA, Stretch JR, Scolyer RA. Subungual melanoma, a study of 124 cases highlighting features of early lesions, potential for histologic reports. Am J Surg Pathol. 2007;31:1902–11.PubMedGoogle Scholar
  46. 46.
    Phan A, Touzet S, Dalle S, Ronger-Savlé S, Balme B, Thomas L. Acral lentiginous melanoma: a study of 126 cases. Br J Derm. 2006;155:561–9.Google Scholar
  47. 47.
    Cohen T, Busam KJ, Patel A, Brady MS. Subungual melanoma: management considerations. Am J Surg. 2008;95:244–8.Google Scholar
  48. 48.
    Hu DN, Wakamatsu K, Ito S, McCormick SA. Comparison of eumelanin and pheomelanin content between cultured uveal melanoma cells and normal uveal melanocytes. Melanoma Res. 2009;19:75–9.PubMedGoogle Scholar
  49. 49.
    Simon JD, Peles D, Wakamatsu K, Ito S. Current challenges in understanding melanogenesis: bringing chemistry, biological control, morphology and function. Pigment Cell Res. 2009;22:563–79.Google Scholar
  50. 50.
    Koga H, Yoshikawa S, Shinohara T, Le Gal F-A, Cortés B, Saida T, Sota T. Long-term follow-up of longitudinal melanonychia in children and adolescents using an objective discrimination index. Acta Derm Venereol. 2016;96:716. Epub ahead of print.PubMedGoogle Scholar
  51. 51.
    Baran R, Kechijian P. Huchtinson’s sign: a reappraisal. J Am Acad Dermatol. 1996;34:87–90.PubMedGoogle Scholar
  52. 52.
    Baran R, Barrière H. Longitudinal melanonychia with spreading pigmentation in Laugier-Hunziker syndrome, a report of two cases. Br J Dermatol. 1986;115:707–10.PubMedGoogle Scholar
  53. 53.
    Asahina A, Matsuyama T, Tsuchida T, Nakagawa H, Seki T, Otsuka F, Ishibashi Y. Two cases of infantile subungual pigmented nevi with Hutschinson’s sign. Nihon Hifuka Gakkai Zasshi. 1989;99:899–906.PubMedGoogle Scholar
  54. 54.
    Shelley WB, Rawnsley HM, Pillsbury DM. Post-irradiation melanonychia. Arch Dermatol. 1964;90:174–6.PubMedGoogle Scholar
  55. 55.
    Bisht DB, Singh SS. Pigmented bands on nails, a new sign in malnutrition. Lancet. 1962;1:1175–81.Google Scholar
  56. 56.
    Mallon E, Dawber RP. Longitudinal melanonychia induced by minocycline. Br J Dermatol. 1994;130:794–5.PubMedGoogle Scholar
  57. 57.
    Gallais V, Lacour JP, Perrin C, Ghanem G, Bodokh I, Ortonne JP. Acral hyperpigmented macules and longitudinal melanonychia in AIDS patients. Br J Dermatol. 1992;126:387–91.PubMedGoogle Scholar
  58. 58.
    Bayerl C, Moll I. Striped nail pigmentation with Hutchinson sign in boxer. Hautarzt. 1993;44:476–9.PubMedGoogle Scholar
  59. 59.
    Kawabata Y, Ohara K, Hino H, Tamaki K. Two kinds of Hutchinson’s sign, benign and malignant. J Am Acad Dermatol. 2001;44:305–7.PubMedGoogle Scholar
  60. 60.
    Sawada M, Ishizaki S, Ken Kobayashi K, Dekio I, Tanaka M. Longterm digital monitoring in the diagnosis and management of congenital nevi of the nail apparatus showing pseudo-Hutchinson’s sign. Dermatol Pract Concept. 2014;4(2):37–40.PubMedPubMedCentralGoogle Scholar
  61. 61.
    Liu Y, Wang L. The rare occurrence of three subungual melanomas in one patient. J Cutan Pathol. 2012;39:286–68.PubMedGoogle Scholar
  62. 62.
    Kopf AW, Waldo E. Melanonychia striata. Australas J Dermatol. 1980;21:59–70.PubMedGoogle Scholar
  63. 63.
    Thai KE, Young R, Sinclair RD. Nail apparatus melanoma. Australas J Dermatol. 2001;42:71–81.PubMedGoogle Scholar
  64. 64.
    Kikuchi I, Inoue S, Sakaguchi E, Ono T. Regressing nevoid nail area melanosis in childhood. Dermatology. 1983;186:88–93.Google Scholar
  65. 65.
    Tosti A, Baran R, Morelli R, Fanti PA, Peserico A. Progressive fading of longitudinal melanonychia due to a nail matrix melanocytic nevus in a child. Arch Dermatol. 1994;130:1076–7.PubMedGoogle Scholar
  66. 66.
    Ohtsuka H, Hori Y, Ando M. Nevus of the little finger with a remarkable nail deformity: case report. Plast Reconstr Surg. 1978;61:108–11.PubMedGoogle Scholar
  67. 67.
    Coskey RJ, Magnell TD, Bemacki EG Jr. Congenital subungual nevus. J Am Acad Dermatol. 1983;9:747–51.PubMedGoogle Scholar
  68. 68.
    Libow LF, Casey TJ, Varela CD. Congenital subungual nevus in a black infant. Cutis. 1995;56:154–6.PubMedGoogle Scholar
  69. 69.
    Goldminz AM, Wolpowitz D, Gottlieb AB, Krathen MS. Congenital subungual melanocytic nevus with a pseudo-Hutchinson sign. Dermatol Online J. 2013;19(4):8.PubMedGoogle Scholar
  70. 70.
    Cooper C, Arva NC, Lee C, Yélamos O, Obregon R, Sholl LM, Wagner A, Shen L, Guitart J, Gerami P. A clinical, histopathologic, and outcome study of melanonychia striata in childhood. J Am Acad Dermatol. 2015;72:773–9.Google Scholar
  71. 71.
    Graham J. Pathology of dermatophytosis. Presented at the 10th Combined Skin Pathology Course, Philadelphia, PA, Sept 19, 1995.Google Scholar
  72. 72.
    Grammer-West NY, Corvette DM, Giandoni MB, Fitzpatrick JE. Clinical pearl: nail plate biopsy for the diagnosis of psoriatic nails. J Am Acad Dermatol. 1998;38:260–2.PubMedGoogle Scholar
  73. 73.
    Haneke E. Clinical judgement. A lesson derived from a subungual melanoma. Dermatopathol Pract Concept. 2000;6:73–6.Google Scholar
  74. 74.
    Weedon D, Van Deurse M, Rosendahl C. “Occult” melanocytes in nail matrix melanoma. Am J Dermatopathol. 2012;34:855.PubMedGoogle Scholar
  75. 75.
    Izumi M, Ohara K, Hoashi T, Nakayama H, Chiu CS, Nagai T, Matsubayashi J, Iwaya K, Mukai K. Subungual melanoma: histological examination of 50 cases from early stage to bone invasion. J Dermatol. 2008;35:695–703.PubMedGoogle Scholar
  76. 76.
    Kleinerman R, Kriegel D, Amir I, Emanuel PO, Markinson BC. Osteoinvasive subungual melanoma: a case and review. J Drug Dermatol. 2010;9:159–63.Google Scholar
  77. 77.
    Nakamura Y, Fujisawa Y, Teramoto Y, Sato S, Yamada K, Sekine K, Fujimoto M, Otsuka F, Yamamoto A. Tumor-to-bone distance of invasive subungual melanoma: an analysis of 30 cases. J Dermatol. 2014;41:872–7.PubMedGoogle Scholar
  78. 78.
    Motta A, López C, Acosta A, Peñaranda C. Subungual melanoma in situ in a Hispanic girl treated with functional resection and reconstruction with onychocutaneous toe free flap. Arch Dermatol. 2007;143:1600–2.PubMedGoogle Scholar
  79. 79.
    Tosti A, Piraccini BM, Cagalli A, Haneke E. In situ melanoma of the nail unit in children: report of two cases in fair-skinned caucasian children. Ped Dermatol. 2012;29:79–83.Google Scholar
  80. 80.
    Mones JM, Ackerman AB. Melanomas in prepubescent children: review comprehensively, critique historically, criteria diagnostically, and course biologically. Am J Dermatopathol. 2003;25:223–38.PubMedGoogle Scholar
  81. 81.
    Bastian BC, Kashani-Sabet M, Hamm H, Godfrey T, Moore DH 2nd, Bröcker EB, LeBoit PE, Pinkel D. Gene amplifications characterize acral melanoma and permit the detection of occult tumor cells in the surrounding skin. Cancer Res. 2000;60:1968–73.PubMedGoogle Scholar
  82. 82.
    Bauer J, Bastian B. Genomic analysis of melanocytic neoplasia. Adv Dermatol. 2005;21:81–99.PubMedGoogle Scholar
  83. 83.
    Curtin JA, Fridlyand J, Kageshita T, Patel HN, Busam KJ, Kutzner H, Cho KH, Aiba S, Bröcker EB, LeBoit PE, Pinkel D, Bastian BC. Distinct sets of genetic alterations in melanoma. N Engl J Med. 2005;353:2135–47.PubMedPubMedCentralGoogle Scholar
  84. 84.
    Bauer J, Bastian BC. Distinguishing melanocytic nevi from melanoma by DNA copy number changes: comparative genomic hybridization as a research and diagnostic tool. Dermatol Ther. 2006;19:40–9.PubMedGoogle Scholar
  85. 85.
    Viros A, Fridlyand J, Bauer J, Lasithiotakis K, Garbe C, Pinkel D, Bastian BC. Improving melanoma classification by integrating genetic and morphologic features. PLoS Med. 2008;5(6):e120.PubMedPubMedCentralGoogle Scholar
  86. 86.
    Fargnoli MC, Pike K, Pfeiffer RM, Tsang S, Rozenblum E, Munroe DJ, Golubeva Y, Calista D, Seidenari S, Massi D, Carli P, Bauer J, Elder DE, Bastian BC, Peris K, Landi MT. MC1R variants increase risk of melanomas harboring BRAF mutations. J Invest Dermatol. 2008;128:2485–90.PubMedPubMedCentralGoogle Scholar
  87. 87.
    Gerami P, Jewell SS, Morrison LE, Blondin B, Schulz J, Ruffalo T, Matushek P 4th, Legator M, Jacobson K, Dalton SR, Charzan S, Kolaitis NA, Guitart J, Lertsbarapa T, Boone S, LeBoit PE, Bastian BC. Fluorescence in situ hybridization (FISH) as an ancillary diagnostic tool in the diagnosis of melanoma. Am J Surg Pathol. 2009;33:1146–56.PubMedGoogle Scholar
  88. 88.
    Wynes J, Wanat KA, Huen A, Mlodzienski AJ, Rubin AI. Pigmented onychomatricoma: a rare pigmented nail unit tumor presenting as longitudinal melanonychia that has potential for misdiagnosis as melanoma. J Foot Ankle Surg. 2015;54:723–5.PubMedGoogle Scholar
  89. 89.
    Nakandakari S, Coelho APCP, Marques GF, Soares CT. Melanonychia striata secondary to pigmented nail matrix fibroma simulating nodular melanoma. Surg Cosmet Dermatol. 2015;7:356–60.Google Scholar
  90. 90.
    Bon-Mardion M, Poulalhon N, Balme B, Thomas L. Ungual seborrheic keratosis. J Eur Acad Dermatol Venereol. 2010;24:1102–4.PubMedGoogle Scholar
  91. 91.
    Stinco G, Errichetti E, Patrone P. Ungual seborrhoeic keratosis: report of a case and its dermoscopic features. J Eur Acad Dermatol Venereol. 2016;30:481–3.PubMedGoogle Scholar
  92. 92.
    Perrin C, Cannata GE, Bossard C, Grill JM, Ambrossetti D, Michiels JF. Onychocytic matricoma presenting as pachymelanonychia longitudinal. A new entity (report of five cases). Am J Dermatopathol. 2012;34:54–9.PubMedGoogle Scholar
  93. 93.
    Perrin C, Langbein L, Ambrossetti D, Erfan N, Schweizer J, Michiels JF. Onychocytic carcinoma: a new entity. Am J Dermatopathol. 2013;35:679–84.PubMedGoogle Scholar
  94. 94.
    Baran R, Perrin C. Linear melanonychia due to subungual keratosis of the nail bed: a report of two cases. Br J Dermatol. 1999;140:730–3.PubMedGoogle Scholar
  95. 95.
    Miteva M, Fanti PA, Romanelli P, Zaiac M, Tosti A. Onychopapilloma presenting as longitudinal melanonychia. J Am Acad Dermatol. 2012;66:e242–3.PubMedGoogle Scholar
  96. 96.
    Baran R, Eichmann A. Longitudinal melanonychia associated with Bowen’s disease: two new cases. Dermatology. 1993;186:159–60.PubMedGoogle Scholar
  97. 97.
    Lambiase MC, Gardner TL, Altman CE, Albertini JG. Bowen disease of the nail bed presenting as longitudinal melanonychia: detection of human papillomavirus type 56 DNA. Cutis. 2003;72:305–9.PubMedGoogle Scholar
  98. 98.
    Saito T, Uchi H, Moroi Y, Kiryu H, Furue M. Subungual Bowen disease revealed by longitudinal melanonychia. J Am Acad Dermatol. 2012;67:e240–1.Google Scholar
  99. 99.
    Stetsenko GY, McFarlane RJ, Chien AJ, Fleckman P, Swanson P, George E, Argenyi ZB. Subungual Bowen disease in a patient with epidermodysplasia verruciformis presenting clinically as longitudinal melanonychia. Am J Dermatopathol. 2008;30:582–5.PubMedGoogle Scholar
  100. 100.
    Ishida M, Iwai M, Yoshida K, Kagotani A, Okabe H. Subungual pigmented squamous cell carcinoma presenting as longitudinal melanonychia: a case report with review of the literature. Int J Clin Exp Pathol. 2014;7:844–7. eCollection 2014.PubMedPubMedCentralGoogle Scholar
  101. 101.
    Shimizu A, Tamura A, Abe M, Amano H, Motegi S, Nakatani Y, Hoshino H, Ishikawa O. Human papillomavirus type 56-associated Bowen disease. Br J Dermatol. 2012;167:1161–4.PubMedGoogle Scholar
  102. 102.
    Shimizu A, Tamura A, Abe M, Motegi S, Nagai Y, Ishikawa O, Nakatani Y, Yamamoto Y, Uezato H, Hoshino H. Detection of human papillomavirus type 56 in Bowen’s disease involving the nail matrix. Br J Dermatol. 2008;158:1273–9.PubMedGoogle Scholar
  103. 103.
    Sass U, André J, Stene JJ, Noel JC. Longitudinal melanonychia revealing an intraepidermal carcinoma of the nail apparatus: detection of integrated HPV-16 DNA. J Am Acad Dermatol. 1998;39:490–3.PubMedGoogle Scholar
  104. 104.
    Rudolph RI. Subungual basal cell carcinoma presenting as longitudinal melanonychia. J Am Acad Dermatol. 1987;16:229–33.PubMedGoogle Scholar
  105. 105.
    Haenssle HA, Buhl T, Holzkamp R, Schön MP, Kretschmer L, Bertsch HP. Squamomelanocytic tumor of the nail unit metastasizing to a sentinel lymph node: a dermoscopic and histologic investigation. Dermatology. 2012;225:127–30.PubMedGoogle Scholar
  106. 106.
    Ferreira O, Baudrier T, Mota A, Tellechea O, Cruz MJ, Guimarães M, Magalhães J, Azevedo F. Onycotrychia?: subungual hair follicle as another cause of longitudinal melanonychia or pigmentation  – hair follicle as cause of melanonychia. J Eur Acad Dermatol Venereol. 2010;24:1238–40.Google Scholar
  107. 107.
    Cerman AA. Subungual ectopic hair. J Eur Acad Dermatol Venereol. 2011;25:1115–6.PubMedGoogle Scholar
  108. 108.
    Emeksiz MC, Uzar KM. Subungual ectopic hair (Onycotrychia). J Eur Acad Dermatol Venereol. 2014;28:1263–4.PubMedGoogle Scholar
  109. 109.
    De Vasconcelos P, Goyri-O’Neill J, Soares-Almeida L, Ferreira J, Filipe P. Subungual ectopic hair studied by scanning electron microscopy. J Eur Acad Dermatol Venereol. 2016;30:472–3.PubMedGoogle Scholar
  110. 110.
    de Berker D, Dawber R, Wojnarowska F. Subungual hair implantation in hairdressers. Br J Dermatol. 1994;130:400–1.PubMedGoogle Scholar
  111. 111.
    Nagtzaam IF, van der Velden JJ, Kelleners-Smeets NW, Frank J. Onycholysis associated with subungual manifestation of barber’s hair sinus. Int J Dermatol. 2007;46(Suppl 3):48–9.PubMedGoogle Scholar
  112. 112.
    Hogan DJ. Subungual trichogranuloma in a hairdresser. Cutis. 1988;42:105–6.PubMedGoogle Scholar
  113. 113.
    Sato T, Tanaka M. The reason for red streaks on dermoscopy in the distal part of a subungual hemorrhage. Dermatol Pract Concept. 2013;4(2.):18):83–5.Google Scholar
  114. 114.
    Haneke E, Baran R. Subunguale Tumoren. Z Hautkr. 1982;57:355–62.PubMedGoogle Scholar
  115. 115.
    Poudyal S, Elpern DJ. Simple diagnostic tests for subungual pigmentation. Dermatol Pract Res. 2009;2009:278040. Scholar
  116. 116.
    Hafner J, Haenseler E, Ossent P, Burg G, Panizzon RG. Benzidine stain for the histochemical detection of hemoglobin in splinter hemorrhage (subungual hematoma) and black heel. Am J Dermatopathol. 1995;17:362–7.PubMedGoogle Scholar
  117. 117.
    Perrin C, Baran R. Longitudinal melanonychia caused by Trichophyton rubrum. Histochemical and ultrastructural study of two cases. J Am Acad Dermatol. 1994;31:311–6.PubMedGoogle Scholar
  118. 118.
    Vélez A, Fernández-Roldán JC, Linares M, Casal M. Melanonychia due to Candida humicola. Br J Dermatol. 1996;134:375–6.PubMedGoogle Scholar
  119. 119.
    Parlak AH, Goksugur N, Karabay O. A case of melanonychia due to Candida albicans. Clin Exp Dermatol. 2006;31:398–400.PubMedGoogle Scholar
  120. 120.
    Cho E, Lee YB, Park HJ, Cho BK. Fungal melanonychia due to Candida albicans. Int J Dermatol. 2013;52:1598–600.PubMedGoogle Scholar
  121. 121.
    Finch J, Arenas R, Baran R. Fungal melanonychia. J Am Acad Dermatol. 2012;66:830–41.Google Scholar
  122. 122.
    de Carvalho LM, Mendonça I, de Oliveira JC, Val A, Hering B, Stallone C, Jimenez PA. Melanoníquia: a propósito de um caso de micotização ungueal simulando melanoma. Dermatol Online J. 2010;16(3):6.PubMedGoogle Scholar
  123. 123.
    Hamasaka E, Akiyama M, Hata H, Aoyagi S, Shimizu H. Melanonychia caused by Stenotrophomonas maltophilia. Clin Exp Dermatol. 2009;34:242–3.PubMedGoogle Scholar
  124. 124.
    Lo Schiavo AL, Gambardella A, Caccavale S. Fungal melanonychia and Exophiala dermatitidis. Mycoses. 2013;56:187–8.PubMedGoogle Scholar
  125. 125.
    Garcia C, Arenas R, Vasquez del Mercado E. Subungual black onychomycosis and melanonychia striata caused by Aspergillus niger. Skinmed. 2015;13:104–6.Google Scholar
  126. 126.
    Haneke E, Baran R. Longitudinal melanonychia. Dermatol Surg. 2001;27:580–4.Google Scholar
  127. 127.
    Zuehlke RL, Taylor WB. Black nails with Proteus mirabilis. Arch Dermatol. 1970;102:154–5.PubMedGoogle Scholar
  128. 128.
    Qadripur SA, Schauder S, Schwartz P. Ungues nigri durch Proteus mirabilis. Hautarzt. 2001;52:658–61.PubMedGoogle Scholar
  129. 129.
    Cohen PR. Hydroxychloroquine-associated hyperpigmentation mimicking elder abuse. Dermatol Ther (Heidelb). 2013;3:203–10.Google Scholar
  130. 130.
    Haneke E. Operative Therapie akraler und subungualer Melanome. In: Rompel R, Petres J, editors. Operative und onkologische Dermatologie. Fortschritte der operativen und onkologischen Dermatologie, vol. 15. Berlin: Springer; 1999. p. 210–4.Google Scholar
  131. 131.
    Haneke E. Melanonychia longitudinalis und andere braune Nagelpigmentierungen. In: Koller J, Hintner H, editors. Fortschritte der operativen und onkologischen Dermatologie, vol. 16. Berlin: Blackwell Wissenschaftsverlag; 2000. p. 19–26.Google Scholar
  132. 132.
    Duarte AF, Correia O, Barros AM, Azevedo R, Haneke E. Nail matrix melanoma in situ: conservative surgical management. Dermatology. 2010;220:173–5.PubMedGoogle Scholar
  133. 133.
    Joggi IA, Perruchoud DL, Hunger R, Beltraminelli H, Blum R, Haneke E. Subunguales Melanom der Nagelmatrix mit longitudinaler Melanonychie: Stellung der konservativen chirurgischen Therapie. Dermatol Helv. 2015;27(7):20–2.Google Scholar
  134. 134.
    Haneke E, Binder D. Subunguales Melanom mit streifiger Nagelpigmentierung. Hautarzt. 1978;29:389–91.PubMedGoogle Scholar
  135. 135.
    Duarte AF, Correia O, Barros AM, Ventura F, Haneke E. Nail melanoma in situ: clinical, dermoscopic, pathologic clues, and steps for minimally invasive treatment. Dermatol Surg. 2015;41:59–68.PubMedGoogle Scholar
  136. 136.
    Haneke E, Nakamura RC, Papaiordanou F, Machado EA, D’Almeida LF. Cirurgia conservadora em caso de melanoma subungueal in situ. Conservative surgery of subungual melanoma in situ. Surg Cosmet Dermatol. 2016;8:70–2.Google Scholar
  137. 137.
    North JP, Kageshita T, Pinkel D, LeBoit PE, Bastian BC. Distribution and significance of occult intraepidermal tumor cells surrounding primary melanoma. J Invest Dermatol. 2008;128:2024–30.PubMedPubMedCentralGoogle Scholar
  138. 138.
    Haneke E. Pathogenese der Nageldystrophie beim subungualen Melanom. Verh Dtsch Ges Pathol. 1986;70:484.Google Scholar
  139. 139.
    Chow WT, Bhat W, Magdub S, Orlando A. In situ subungual melanoma: Digit salvaging clearance. J Plast Reconstr Aesthet Surg. 2013;66:274–6.PubMedGoogle Scholar
  140. 140.
    Shin HT, Jang KT, Mun GH, Lee DY, Lee JB. Histopathological analysis of the progression pattern of subungual melanoma: late tendency of dermal invasion in the nail matrix area. Mod Pathol. 2014;27:1461–7.PubMedGoogle Scholar
  141. 141.
    Kim JY, Jung HJ, Lee WJ, Kim DW, Yoon GS, Kim DS, Park MJ, Lee SJ. Is the distance enough to eradicate in situ or early invasive subungual melanoma by wide local excision? From the point of view of matrix-to-bone distance for safe inferior surgical margin in Koreans. Dermatology. 2011;223:122–3.PubMedGoogle Scholar
  142. 142.
    Haneke E. Ungual melanoma – controversies in diagnosis and treatment. Dermatol Ther. 2012;25:510–24.PubMedGoogle Scholar
  143. 143.
    Maekawa T, Komine M, Murata S, Ohtsuki M. Surgical treatment of subungual melanoma: a case treated with bone splitting of the distal phalanx. J Dermatol. 2014;41:944–6.PubMedGoogle Scholar
  144. 144.
    Slingluff CL Jr, Vollmer R, Seigler HF. Acral melanoma: a review of 185 patients with identification of prognostic variables. J Surg Oncol. 1990;45:91–9.PubMedGoogle Scholar
  145. 145.
    Park KG, Blessing K, Kernohan NM. Surgical aspects of subungual malignant melanomas. The Scottish Melanoma Group Ann Surg. 1992;216:692–5.PubMedGoogle Scholar
  146. 146.
    Orfanos CE, Jung EG, Rassner G, Wolff HH, Garbe C. Stellungnahme und Empfehlungen der Kommission malignes Melanom der Deutschen Dermatologischen Gesellschaft zur Diagnostik, Behandlung und Nachsorge des malignen Melanoms der Haut. Stand 1993/94. Hautarzt. 1994;45:285–91.PubMedGoogle Scholar
  147. 147.
    Finley RK 3rd, Driscoll DL, Blumenson LE, Karakousis CP. Subungual melanoma: an eighteen-year review. Surgery. 1994;116:96–100.PubMedGoogle Scholar
  148. 148.
    Quinn MJ, Thompson JE, Crotty K, McCarthy WH, Coates AS. Subungual melanoma of the hand. J Hand Surg [Am]. 1996;21:506–11.Google Scholar
  149. 149.
    O’Leary JA, Berend KR, Johnson JL, Levin LS, Seigler HF. Subungual melanoma. A review of 93 cases with identification of prognostic variables. Clin Orthop Relat Res. 2000;378:206–12.Google Scholar
  150. 150.
    Rigby HS, Briggs JC. Subungual melanoma: a clinico-pathological study of 24 cases. Br J Plast Surg. 1992;45:275–8.PubMedGoogle Scholar
  151. 151.
    Campbell WJ, Harper CV, Alderdice JM, Humphreys WG. Subungal melanoma. Ir J Med Sci. 1990;159:145–6.PubMedGoogle Scholar
  152. 152.
    Nguyen JT, Bakri K, Nguyen EC, Johnson CH, Moran SL. Surgical management of subungual melanoma: Mayo clinic experience of 124 cases. Ann Plast Surg. 2013;71:346–54.PubMedGoogle Scholar
  153. 153.
    Gregorcyk S, Shelton RM, Ladaga LE, Perry RR. Pathologic fracture secondary to subungual melanoma. J Surg Oncol. 1996;61:230–3.PubMedGoogle Scholar
  154. 154.
    Sone Y, Namiki T, Munetsugu T, Ueno M, Tokoro S, Nishizawa A, Takayama K, Yokozeki H. A case of subungual melanoma with bone invasion: destructive local invasion and multiple skin metstases. J Eur Acad Dermatol Venereol. 2016;30:1049–50.PubMedGoogle Scholar
  155. 155.
    Moehrle M, Metzger S, Schippert W, Garbe C, Rassner G, Breuninger H. “Functional” surgery in subungual melanoma. Dermatol Surg. 2003;29:366–74.PubMedGoogle Scholar
  156. 156.
    Lazar A, Abimelec P, Dumontier C. Full thickness skin graft for nail unit reconstruction. J Hand Surg (Br). 2005;30:194–8.Google Scholar
  157. 157.
    Ogata D, Uhara H, Tsutsumida A, Yamazaki N, Mochida K, Amano M, Yoshikawa S, Kiyohara Y, Tsuchida T. Nail apparatus melanoma in a Japanese population: a comparative study of surgical procedures and prognoses in a large series of 151 cases. Eur J Dermatol 2017;27(6):620–26.Google Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Eckart Haneke
    • 1
    • 2
    • 3
    • 4
  1. 1.Department of Dermatology, InselspitalUniversity of BernBerneSwitzerland
  2. 2.Dermatology Practice DermaticumFreiburgGermany
  3. 3.Centro de Dermatología Epidermis, Instituto CUFPortoPortugal
  4. 4.Department of Dermatology, Academic HospitalUniversity of GentGhentBelgium

Personalised recommendations