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Non Melanocytic Pigment Abnormalities

  • Molly Hinshaw
Chapter

Abstract

Pigmentary disorders of the nails are frequent diagnostic and therapeutic challenges. Diagnostic challenges exist because physical examination findings do not always distinguish between non-melanocytic and melanocytic disorders. Lesions may evolve over time and early lesions may not yet have features definitively diagnostic. The condition frequently comes to medical attention with concern for melanoma. Therefore, of primary importance during the physical examination is to determine whether the pigmentary disorder is caused by too much melanin (melanocyte activation) or by an increased number of melanocytes (e.g. nevi, melanoma). If this distinction cannot be made and a biopsy is necessary, then one must be aware of and plan for intraoperative and postoperative issues that will determine whether or not an adequate diagnosis can be made. These include adequate sampling by the surgeon and interpretation by the dermatopathologist. In this chapter, a systematic approach to the physical examination and subsequent decision-making will be discussed as means by which to distinguish non-melanocytic from melanocytic causes of nail pigmentation.

Keywords

Nail pigmentation Hyperpigmentation Melanonychia Melanonychia striata Melanocyte activation Pseudo-Hutchinson’s sign Pigmented fungus Trauma Talon noire Nail Biopsy 

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© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Dermatology and Dermatopathology, UWSMPHMadisonUSA

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