When A Patient Presents With Longitudinal Nail Pigmentation

Volume 25 - Issue 6 - June 2012
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Nail Pigment Changes That Should Undergo Biopsy

1. Isolated pigmented band on a single digit that develops during fourth to sixth decade of life (although melanoma can occur in children, it is a very rare event)
2. Nail pigmentation that develops abruptly in a previously normal nail plate
3. Pigmentation that suddenly becomes darker or larger, or pigment becomes blurred near nail matrix
4. Acquired pigmentation of thumb, index finger, or large toe
5. Pigment that develops after a history of digital trauma and in which one has ruled out subungual hematoma
6. Any acquired lesion in patients with a personal history of melanoma
7. If pigmentation is associated with nail dystrophy including partial nail destruction or absence of nail plate
8. If pigmentation of periungual skin (including lateral nailfolds) is found to be present (Hutchinson’s sign); this includes pigment of cuticle or hyponychium

Author(s):

M. Joel Morse, DPM

References
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