Friday, 26 April 2013

Racial longitudinal melanonychia

Melanonychia is a brown to black colour of the nail. It is due to the presence of melanin in the nail plate. It is caused by activation or benign/malignant proliferation of nail matrix melanocytes.

When the pigmentation involves the whole nail it is called total melanonychia. When it is banded it is either transverse or longitudinal. Longitudinal melanonychia is the commonest form. The commonest cause of longitudinal melanonychia in adults is racial variation (see photo), trauma has been implicated in their development. The commonest cause in children is benign melanocytic hyperplasia.

Longitudinal melanonychia of a single nail deserves biopsy in adults as a high degree of suspicion is required if subungual melanoma (or another pigmented malignancy) is not to be missed.  In children it is usually benign in nature and can be followed

Racial longitudinal melanonychia

This page was last updated in April 2013

Main Works of Reference List (The first eight are my top favourites)

  • British National Formulary
  • British National Formulary for Children
  • Guidelines (BAD - BASHH - BHIVA - Uroweb)
  • Oxford Handbook of Genitourinary Medicine, HIV, and Sexual Health
  • Oxford Handbook of Medical Dermatology
  • Rook's Textbook of Dermatology
  • Simple Skin Surgery
  • Weedon's Skin Pathology
  • A Concise Atlas of Dermatopathology (P Mckee)
  • Andrews' Diseases of the Skin
  • Andrology (Nieschlag E FRCP, Behre M and Nieschlag S)
  • Bailey and Love's Short Practice of Surgery
  • Davidson's Essentials of Medicine
  • Davidson's Principles and Practice of Medicine
  • Fitzpatrick's Colour Atlas and Synopsis of Clinical Dermatology (Klaus Wolff FRCP and Richard Allen Johnson)
  • Fitzpatrick’s Dermatology in General Medicine
  • Ganong's Review of Medical Physiology
  • Gray's Anatomy
  • Hamilton Bailey's Demonstrations of Physical Signs in Clinical Surgery
  • Hutchison's Clinical Methods
  • Lever's Histopathology of the Skin
  • Lever's Histopathology of the Skin (Atlas and Synopsis)
  • Macleod's Clinical Examination
  • Martindale: The Complete Drug Reference
  • Oxford Handbook of Clinical Examination and Practical Skills
  • Oxford Textbook of Medicine
  • Practical Dermatopathology (R Rapini)
  • Sexually Transmitted Diseases (Holmes K et al)
  • Statistics in Clinical Practice (D Coggon FRCP)
  • Stockley's Drug Interactions
  • Treatment of Skin Disease: Comprehensive Therapeutic Strategies
  • Yen & Jaffe's Reproductive Endocrinology