title: Patterns of nail matrix and bed of longitudinal melanonychia by intraoperative dermatoscopy.
abstract: BACKGROUND
  The dermatoscopic examination of the nail plate has been recently introduced for the evaluation of pigmented nail lesions. There is, however, no evidence that this technique improves diagnostic accuracy of in situ melanoma.
  
  
  OBJECTIVE
  To establish and validate patterns for intraoperative dermatoscopy of the nail matrix.
  
  
  METHODS
  Intraoperative nail matrix dermatoscopy was performed in 100 consecutive bands of longitudinal melanonychia that were excised and submitted to histopathologic examination.
  
  
  RESULTS
  We identified 4 dermatoscopic patterns: regular gray pattern (hypermelanosis), regular brown pattern (benign melanocytic hyperplasia), regular brown pattern with globules or blotch (melanocytic nevi), and irregular pattern (melanoma).
  
  
  CONCLUSIONS
  Nail matrix dermatoscopy is an invasive procedure that can not routinely be performed in all cases of melanonychia.
  
  
  CONCLUSIONS
  The patterns described present high sensitivity and specificity for intraoperative differential diagnosis of pigmented nail lesions.
authors.affiliation: Department of Dermatology, Universidade Federal de São Paulo, São Paulo, Brazil.
authors.forename: Sergio Henrique
authors.initials: SH
authors.lastname: Hirata
authors.affiliation: Department of Dermatology, Universidade Federal de São Paulo, São Paulo, Brazil.
authors.forename: Sergio
authors.initials: S
authors.lastname: Yamada
authors.affiliation: Department of Dermatology, Universidade Federal de São Paulo, São Paulo, Brazil.
authors.forename: Mauro Yoshiaki
authors.initials: MY
authors.lastname: Enokihara
authors.affiliation: Dermatology Clinic, Hospital do Servidor Público Municipal São Paulo, São Paulo, Brazil.
authors.forename: Nilton
authors.initials: N
authors.lastname: Di Chiacchio
authors.affiliation: Department of Dermatology, Universidade Federal de São Paulo, São Paulo, Brazil.
authors.forename: Fernando Augusto
authors.initials: FA
authors.lastname: de Almeida
authors.affiliation: Department of Pathology, Universidade Federal de São Paulo, São Paulo, Brazil.
authors.forename: Milvia Maria S S
authors.initials: MMSS
authors.lastname: Enokihara
authors.affiliation: Department of Pathology, Universidade Federal de São Paulo, São Paulo, Brazil.
authors.forename: Nilceo Schwery
authors.initials: NS
authors.lastname: Michalany
authors.affiliation: Great Miami Skin and Laser Center, Miami, Florida.
authors.forename: Martin
authors.initials: M
authors.lastname: Zaiac
authors.affiliation: Department of Dermatology, University of Bologna, Bologna, Italy.
authors.forename: Antonella
authors.initials: A
authors.lastname: Tosti
mesh_terms: D000328:Adult; D000368:Aged; D015331:Cohort Studies; D046169:Dermoscopy / Q000379:methods*; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007430:Intraoperative Care / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009260:Nail Diseases / Q000175:diagnosis / Q000473:pathology* / Q000601:surgery; D009508:Nevus, Pigmented / Q000175:diagnosis / Q000473:pathology* / Q000601:surgery; D015203:Reproducibility of Results; D018570:Risk Assessment; D012878:Skin Neoplasms / Q000175:diagnosis / Q000473:pathology* / Q000601:surgery