title: Clinical and dermoscopic clues to differentiate pigmented nail bands: an International Dermoscopy Society study.
abstract: BACKGROUND
  Longitudinal melanonychia might be difficult to differentiate and the use of dermoscopy can be useful for the preoperative evaluation and management decision.
  
  
  OBJECTIVE
  The aim of our study was to investigate clinical and dermoscopic criteria of acquired longitudinal melanonychia in adults to identify the best predictors of melanoma using a multivariate analysis and to explore eventual new dermoscopic criteria for nail melanoma diagnosis.
  
  
  METHODS
  In this retrospective observational study, 82 histopathologically diagnosed, acquired nail pigmented bands were collected and examined. All variables were included in the analysis and examined as possible predictors of nail melanoma. Both univariate and multivariable analyses have been performed.
  
  
  RESULTS
  Among 82 cases, 25 were diagnosed as nail melanoma and 57 as benign lesions (including 32 melanocytic nevi and 25 benign melanocytic hyperplasia). Melanoma cases were significantly associated with a width of the pigmented band higher than 2/3 of the nail plate, grey and black colours, irregularly pigmented lines, Hutchinson and micro-Hutchinson signs, and nail dystrophy. Granular pigmentation, a newly defined dermoscopic criterion, was found in 40% of melanomas and only in 3.51% of benign lesions.
  
  
  CONCLUSIONS
  Dermoscopic examination of longitudinal melanonychia provides useful information that could help clinicians to improve melanoma recognition.
authors.affiliation: Skin Cancer Unit, Arcispedale S. Maria Nuova-IRCCS, Reggio Emilia, Italy.
authors.forename: E
authors.initials: E
authors.lastname: Benati
authors.affiliation: Section of Dermatology, Department of Medical Sciences, University of Turin, Turin, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Ribero
authors.affiliation: Skin Cancer Unit, Arcispedale S. Maria Nuova-IRCCS, Reggio Emilia, Italy.
authors.forename: C
authors.initials: C
authors.lastname: Longo
authors.affiliation: Pathology Unit, Arcispedale S. Maria Nuova-IRCCS, Reggio Emilia, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Piana
authors.affiliation: Melanoma Unit, Dermatology and Pathology Departments, Hospital Clínic Barcelona, Universitat de Barcelona, Barcelona, Spain.|CIBER of Rare Diseases, Instituto de Salud Carlos III, Barcelona, Spain.
authors.forename: S
authors.initials: S
authors.lastname: Puig
authors.affiliation: Melanoma Unit, Dermatology and Pathology Departments, Hospital Clínic Barcelona, Universitat de Barcelona, Barcelona, Spain.
authors.forename: C
authors.initials: C
authors.lastname: Carrera
authors.affiliation: Department of Dermatology, Division of General Dermatology, Medical University of Vienna, Vienna, Austria.
authors.forename: F
authors.initials: F
authors.lastname: Cicero
authors.affiliation: Department of Dermatology, Division of General Dermatology, Medical University of Vienna, Vienna, Austria.
authors.forename: H
authors.initials: H
authors.lastname: Kittler
authors.affiliation: Non-Melanoma Skin Cancer Unit, Department of Dermatology and Venerology, Medical University of Graz, Graz, Austria.
authors.forename: T
authors.initials: T
authors.lastname: Deinlein
authors.affiliation: Non-Melanoma Skin Cancer Unit, Department of Dermatology and Venerology, Medical University of Graz, Graz, Austria.
authors.forename: I
authors.initials: I
authors.lastname: Zalaudek
authors.affiliation: Clinic for Dermatology, Allergology, and Environmental Medicine, Klinik Thalkirchner Straße Städt, Klinikum München GmbH, Munich, Germany.
authors.forename: W
authors.initials: W
authors.lastname: Stolz
authors.affiliation: Department of Dermatology, Sheba Medical Center, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: A
authors.initials: A
authors.lastname: Scope
authors.affiliation: Department of Dermatology, University of Modena, Reggio Emilia, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Pellacani
authors.affiliation: Skin Cancer Unit, Arcispedale S. Maria Nuova-IRCCS, Reggio Emilia, Italy.
authors.forename: E
authors.initials: E
authors.lastname: Moscarella
authors.affiliation: Division of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy.
authors.forename: B M
authors.initials: BM
authors.lastname: Piraccini
authors.affiliation: Division of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Starace
authors.affiliation: Dermatology Unit, Second University of Naples, Naples, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Argenziano
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D046169:Dermoscopy; D003937:Diagnosis, Differential; D006801:Humans; D017495:Hyperpigmentation / Q000000981:diagnostic imaging* / Q000209:etiology; D006965:Hyperplasia / Q000150:complications / Q000000981:diagnostic imaging; D008544:Melanocytes / Q000473:pathology*; D008545:Melanoma / Q000150:complications / Q000000981:diagnostic imaging*; D008875:Middle Aged; D009260:Nail Diseases / Q000000981:diagnostic imaging / Q000473:pathology; D009508:Nevus, Pigmented / Q000150:complications / Q000000981:diagnostic imaging*; D012189:Retrospective Studies; D012878:Skin Neoplasms / Q000150:complications / Q000000981:diagnostic imaging*; D055815:Young Adult