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Longitudinal subungual acanthoma: one denomination for various clinical presentations
R Baran1, I Moulonguet2, S Goettmann-Bonvallot3
1Nail Disease Center, Cannes, France.
Summary
Benign longitudinal acanthomas of the nail unit, including keratosis and matricoma, represent a spectrum of diseases. These conditions manifest clinically as melanonychia or leukoxanthonychia due to varying nail unit locations.
Area of Science:
- Dermatopathology
- Oncology
Background:
- Benign subungual proliferations like longitudinal keratosis, seborrheic keratosis, and onychocytic matricoma are proposed to be part of a single disease spectrum.
- These conditions affect the distal nail matrix and bed.
Observation:
- Three new cases of Nail unit longitudinal acanthoma are presented, exhibiting clinical features of longitudinal melanonychia with nail plate thickening (two cases) and leukoxanthonychia (one case).
- These cases are compared with previously described cases, including those resembling seborrheic keratosis.
Findings:
- The study supports the classification of these diverse presentations under a single spectrum termed 'nail unit longitudinal acanthoma', reflecting a shared histopathological process.
- Distinct clinical variations, such as melanonychia and leukoxanthonychia, are attributed to the tumors' anatomic location within the nail unit.
Implications:
- This unified classification simplifies the understanding and diagnosis of benign nail matrix and bed proliferations.
- Recognizing this spectrum aids in differentiating these benign conditions from potentially malignant subungual neoplasms.
- Further research into the specific factors influencing clinical presentation based on anatomic location is warranted.
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