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  • Title: Clinicopathologic features of 28 cases of nail matrix nevi (NMNs) in Asians: Comparison between children and adults.
    Author: Lee JH, Lim Y, Park JH, Lee JH, Jang KT, Kwon EJ, Lee DY.
    Journal: J Am Acad Dermatol; 2018 Mar; 78(3):479-489. PubMed ID: 29107341.
    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.
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