Nail Issues in Diverse Populations

  • Andrew AlexisEmail author
  • Bridget Kaufman


The nail unit is similar between ethnic groups, yet the greater number of activated and differentiated nail matrix melanocytes in darker skin types has important implications on nail appearance and pathogenesis of nail disorders. Longitudinal melanonychia (LM), the presence of a light brown to black linear streak within the nail plate, is more commonly observed in blacks, Asians, and Hispanics due to activation or proliferation of melanocytes within the distal nail matrix. Similarly, the relative frequency of nail apparatus melanoma (compared to other melanoma subtypes) is significantly higher in darker skin phototypes and the overall prognosis appears to be poorer than in whites. These conditions, in addition to other primary nail disorders, medication side effects, cultural practices, and environmental exposures that disproportionately affect certain ethnic groups, are important to consider when treating an increasingly multi-ethnic patient population.


Nail pigmentation Longitudinal melanonychia Melanonychia longitudinalis Nail apparatus melanoma NAM Subungual melanoma Acral lentiginous melanoma Lichen planus Nail LP Onychomycosis Nail fungus Nail salon Ethnic groups Skin of color Cultural practices 

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© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Mount Sinai St. Luke’s and Mount Sinai WestNew YorkUSA

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