Nail unit melanomaThis glossary term has not yet been described. in children is extremely rare and very difficultneeding much effort or skill to accomplish to diagnose . Moreover, unfortunately, clinical as well as dermoscopic criteriameasure of how well one variable or set of variables predicts an outcome used in adults cannot be applied to children since congenital neviis a type of melanocytic nevus (or mole) found in infants at birth. This type of birthmark occurs in an estimated 1% of infants worldwide; it is located in the area of the head and neck 15% of the time. of the nail unit are characterized by signs that are considered extremely suspicious of melanoma in adults.
Triangular shape of the band, irregularity of its pigmentation, nail plate softening or erosionThis glossary term has not yet been described., and periungual pigmentation are very common features of congenital (or congenital-type) neviThis glossary term has not yet been described. of the nail unit. For these reasons, the International Society for DermoscopyThe examination of [skin lesions] with a 'dermatoscope'. This traditionally consists of a magnifier (typically x10), a non-polarised light source, a transparent plate and a liquid medium between the instrument and the skin, and allows inspection of skin lesions unobstructed by skin surface reflections. Modern dermatoscopes dispense with the use of liquid medium and instead use polarised light to cancel out skin surface reflections. (IDSIDS stands for the International Dermoscopy Society.) has created an international register of congenital and congenital-type nevi of the nail unit. To date, this register has included more than 150 cases worldwide of pigmented lesions of the nail unit either present at birth or diagnosed during the first 5 years of life. This ethical committee-approved register is located in Lyons, France, and held by Lyon 1 Claude Bernard University Dermatology Department. Details for submission of cases can be found on the IDS website.
Since this observational study is still ongoing, we will only include here, with few illustrations, some of our preliminary findings. We commonly determined that an irregular pattern of the dermoscopic longitudinal microlines as well as a triangular shape of the whole band were present in early observations. Periungual involvement, also known as Hutchinson’s sign, was also a very common finding, with a remarkable tropism for the toe/fingertip. The pigmentation in the skin distal to the hyponychium often had a longitudinal and parallel disposition perpendicular to the dermatoglyphics. In rare cases with extremely wide involvement of the periungual skinThis glossary term has not yet been described., a disposition of the pigment along the furrows of the dermatoglyphics, reproducing the classic parallel furrow patternVolar pigmentation forming solid or dotted lines, parallel, thin, on the furrows (sulci superficiales or invaginations in dermatoglyphics). The lines are occasionally doubled, each line is beside the furrows. of benign acral nevi, was observed. We also noticed that a more regular pattern of the pigmentation appeared after a few years of evolutionis change in the heritable characteristics of biological populations over successive generations and that, in some cases, the pigmentation faded away almost completely.
Inclusion of new cases in the register is greatly needed and encouraged in order to increase our knowledge of the natural history of congenital nevi of the nail matrixThis glossary term has not yet been described. and to better codify the managementThis glossary term has not yet been described. of these very difficult cases.
ReferencesThis is material contained in a footnote or bibliography holding further information.
- Altamura D, Avramidis M, Menzies SW. (2008) Assessment of the optimal interval for and sensitivityThis glossary term has not yet been described. of short-term sequential digital dermoscopyDermoscopy using digital images. This is used for telemedicine and monitoring. monitoring for the diagnosisis the identification of the nature and cause of a certain phenomenon. Diagnosis is used in many different disciplines with variations in the use of logic, analytics, and experience to determine "cause and effect". In systems engineering and computer science, it is typically used to determine the causes of symptoms, mitigations, and solutions of melanoma. Arch Dermatol 144(4): 502–6.
- Iorizzo M, Tosti A, Di Chiacchio N et al. (2008) Nail melanomaThis glossary term has not yet been described. in children: differential diagnosis and management. Dermatol Surg 34(7): 974–8.
- Richert B, André J. (2011) Nail disorders in children: diagnosis and management. Am J Clin Dermatol 12(2): 101–12.
- Léauté-Labrèze C, Bioulac-Sage P, Taïeb A. (1996) Longitudinal melanonychia in children. A study of eight cases. Arch Dermatol 132(2): 167–9. Erratum in: Arch Dermatol 132(9): 112.
- Wong DE, Brodkin RH, Rickert RR, McFalls SG. (1991) Congenital melanonychia. Int J Dermatol 30(4): 278–80
- Coskey RJ, Magnell TD, Bernacki EG Jr. (1983) Congenital subungual nevusThis glossary term has not yet been described.. J Am Acad Dermatol 9(5): 747–51.
- Caron GA. (1962) Familial congenital pigmented naevi of the nailsThis glossary term has not yet been described.. Lancet 1(7228): 508–9.
- www.dermoscopyThe examination of [skin lesions] with a 'dermatoscope'. This traditionally consists of a magnifier (typically x10), a non-polarised light source, a transparent plate and a liquid medium between the instrument and the skin, and allows inspection of skin lesions unobstructed by skin surface reflections. Modern dermatoscopes dispense with the use of liquid medium and instead use polarised light to cancel out skin surface reflections.–idsIDS stands for the International Dermoscopy Society..org/
- Caron GA. (1962) Familial congenital pigmented naevi of the nails. Lancet 1(7228): 508–9.