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Clinicopathologic features of 28 cases of nail matrix nevi (NMNs) in Asians: Comparison between children and adults.
J Am Acad Dermatol 2018; 78(3):479-489JA

Abstract

BACKGROUND

Clinical distinction between nail matrix nevus (NMN) and subungual melanoma (SUM) can be challenging. More precise delineation of the clinicodermoscopic characteristics specific for NMNs is needed.

OBJECTIVE

We sought to analyze the clinicopathologic features of childhood and adult NMNs and to propose clinicodermoscopic features that can aid in differentiating NMNs from SUM.

METHODS

We retrospectively reviewed clinical, dermoscopic, and histologic findings of patients (20 children and 8 adults) in whom NMN was diagnosed between 2012 and 2015.

RESULTS

Except for 2 cases of total melanonychia, the affected nails demonstrated longitudinal melanonychia sharply demarcated from the adjacent nail plate. Melanonychia was wider among children than among adults (P = .002). Nail dystrophy was more frequent in wider lesions (P = .028). Hutchinson's sign was observed in pediatric cases at the hyponychium and/or proximal nailfold cuticles. All hyponychial pigmentations demonstrated a longitudinal brush pigmentation pattern under dermoscopy.

LIMITATIONS

This was a retrospective study of Asians in a single center.

CONCLUSION

Our study is the largest case series to date of biopsy-confirmed NMNs. It highlighted important clinicodermoscopic differences between pediatric and adult NMNs. We propose that in pediatric cases of longitudinal melanonychia presenting as a sharply demarcated pigment band of even width, the presence of Hutchinson's sign with longitudinal brush pigmentation may favor a diagnosis of NMN over SUM.

Authors+Show Affiliations

Department of Dermatology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.Department of Dermatology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.Department of Dermatology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.Department of Dermatology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.Department of Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.Dermpath Diagnostics, Port Chester, New York.Department of Dermatology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea. Electronic address: dylee@skku.edu.

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

29107341

Citation

Lee, Jae Ho, et al. "Clinicopathologic Features of 28 Cases of Nail Matrix Nevi (NMNs) in Asians: Comparison Between Children and Adults." Journal of the American Academy of Dermatology, vol. 78, no. 3, 2018, pp. 479-489.
Lee JH, Lim Y, Park JH, et al. Clinicopathologic features of 28 cases of nail matrix nevi (NMNs) in Asians: Comparison between children and adults. J Am Acad Dermatol. 2018;78(3):479-489.
Lee, J. H., Lim, Y., Park, J. H., Lee, J. H., Jang, K. T., Kwon, E. J., & Lee, D. Y. (2018). Clinicopathologic features of 28 cases of nail matrix nevi (NMNs) in Asians: Comparison between children and adults. Journal of the American Academy of Dermatology, 78(3), pp. 479-489. doi:10.1016/j.jaad.2017.08.052.
Lee JH, et al. Clinicopathologic Features of 28 Cases of Nail Matrix Nevi (NMNs) in Asians: Comparison Between Children and Adults. J Am Acad Dermatol. 2018;78(3):479-489. PubMed PMID: 29107341.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Clinicopathologic features of 28 cases of nail matrix nevi (NMNs) in Asians: Comparison between children and adults. AU - Lee,Jae Ho, AU - Lim,Youngkyoung, AU - Park,Ji-Hye, AU - Lee,Jong Hee, AU - Jang,Kee-Taek, AU - Kwon,Eun Ji, AU - Lee,Dong-Youn, Y1 - 2017/10/26/ PY - 2017/04/12/received PY - 2017/08/23/revised PY - 2017/08/30/accepted PY - 2017/11/7/pubmed PY - 2018/10/13/medline PY - 2017/11/7/entrez KW - Hutchinson's sign KW - melanonychia KW - nail biopsy KW - nail dystrophy KW - nail matrix nevus KW - retrospective study SP - 479 EP - 489 JF - Journal of the American Academy of Dermatology JO - J. Am. Acad. Dermatol. VL - 78 IS - 3 N2 - BACKGROUND: Clinical distinction between nail matrix nevus (NMN) and subungual melanoma (SUM) can be challenging. More precise delineation of the clinicodermoscopic characteristics specific for NMNs is needed. OBJECTIVE: We sought to analyze the clinicopathologic features of childhood and adult NMNs and to propose clinicodermoscopic features that can aid in differentiating NMNs from SUM. METHODS: We retrospectively reviewed clinical, dermoscopic, and histologic findings of patients (20 children and 8 adults) in whom NMN was diagnosed between 2012 and 2015. RESULTS: Except for 2 cases of total melanonychia, the affected nails demonstrated longitudinal melanonychia sharply demarcated from the adjacent nail plate. Melanonychia was wider among children than among adults (P = .002). Nail dystrophy was more frequent in wider lesions (P = .028). Hutchinson's sign was observed in pediatric cases at the hyponychium and/or proximal nailfold cuticles. All hyponychial pigmentations demonstrated a longitudinal brush pigmentation pattern under dermoscopy. LIMITATIONS: This was a retrospective study of Asians in a single center. CONCLUSION: Our study is the largest case series to date of biopsy-confirmed NMNs. It highlighted important clinicodermoscopic differences between pediatric and adult NMNs. We propose that in pediatric cases of longitudinal melanonychia presenting as a sharply demarcated pigment band of even width, the presence of Hutchinson's sign with longitudinal brush pigmentation may favor a diagnosis of NMN over SUM. SN - 1097-6787 UR - https://www.unboundmedicine.com/medline/citation/29107341/Clinicopathologic_features_of_28_cases_of_nail_matrix_nevi_(NMNs)_in_Asians:_Comparison_between_children_and_adults L2 - https://linkinghub.elsevier.com/retrieve/pii/S0190-9622(17)32317-4 DB - PRIME DP - Unbound Medicine ER -