Diagnosis and management of nail pigmentations.
Longitudinal pigmentation of the nail is very common. The differential diagnosis varies from subungual hematoma, to a fungal infection, to a melanocytic lesion (lentigo, nevus melanoma, etc.) to others. Often, dermatologists do not feel at ease with these pathologies and management is often not clear. In many cases, a biopsy is not helpful because an inadequate technique was chosen. The use of noninvasive techniques such as dermoscopy has been described to be useful for the preoperative evaluation and the management decision. Using these technique, one will be able to reduce the number of unnecessary surgeries and to choose the most adequate biopsy technique. In this article, we will review the management, including diagnosis as well as differential diagnosis of nail pigmentations and propose a new algorithm for the non invasive diagnosis of nail pigmentation.
Braun
Ralph Peter
RP
Pigmented Skin Lesion Unit, Department of Dermatology, University Hospital Geneva, Switzerland. braun@melanoma.ch
Baran
Robert
R
Le Gal
Frederique Anne
FA
Dalle
Stephane
S
Ronger
Sandra
S
Pandolfi
Roberta
R
Gaide
Olivier
O
French
Lars Einar
LE
Laugier
Paul
P
Saurat
Jean Hilaire
JH
Marghoob
Ashfaq Ahmed
AA
Thomas
Luc
L
D001706:Biopsy; D046169:Dermoscopy; D003937:Diagnosis, Differential; D006801:Humans; D009260:Nail Diseases / Q000175:diagnosis* / Q000601:surgery; D010859:Pigmentation Disorders / Q000175:diagnosis* / Q000601:surgery; D012880:Skin Pigmentation / Q000502:physiology