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Longitudinal Melanonychia in Children: Clinical and Histopathologic Features and Management with Literature Update
Isabelle Moulonguet1, Marie Caucanas2, Sophie Goettmann3
1Dermatopathology, Cochin Hospital, 27 Boulevard Saint Jacques, 75014 Paris, France.
Insights
Longitudinal melanonychia (LM) in children is typically benign and often resolves spontaneously. Conservative management with regular monitoring is usually sufficient for pediatric cases.
Area of Science:
- Dermatology
- Pediatric Medicine
- Nail Disorders
Background:
- Longitudinal melanonychia (LM) arises from pigment deposition in the nail plate due to enhanced melanocyte activity in the nail matrix.
- Recent literature has improved understanding of pediatric LM's clinical, histological, and evolutionary aspects.
Purpose of the Study:
- To review and synthesize current literature on pediatric longitudinal melanonychia.
- To clarify the characteristics and management of LM in children.
Main Methods:
- Literature review of publications on pediatric longitudinal melanonychia.
- Examination of clinical, histological, and evolutionary features.
- Analysis of management strategies.
Main Results:
- Pediatric LM is less common than in adults and usually stems from benign nail matrix lesions.
- Clinical warning signs for adults are often not applicable to children.
- Pediatric lesions can exhibit atypical cytology and architecture but follow a benign course.
- Spontaneous regression of pediatric LM is frequent, with band fading or disappearance.
Conclusions:
- Pediatric LM requires specific diagnostic and management approaches distinct from adults.
- Conservative management, including regular follow-up with clinical photography and onychoscopy, is appropriate for most pediatric cases.
Abstract:
Longitudinal melanonychia (LM) results from the deposition of pigment in the nail plate due to increased melanocytic activity within the nail matrix. Recent publications on this topic have helped clarify the main clinical, histological, and evolutionary characteristics of pediatric LM and provide guidance for its appropriate management. In this review, we will examine the literature on the subject. LM is far less common in children than in adults and is most often caused by benign nail matrix lesions. Pediatric LM has specific clinical and histopathologic features, and many of the clinical warning signs used in adults are not applicable to children. Pediatric lesions may show atypical cytologic and even architectural features yet still follow a benign clinical course. Spontaneous regression of LM is common in children, with fading and narrowing of the pigmented band, or even complete disappearance. The vast majority of pediatric LM cases can be managed conservatively with regular follow-up, including clinical photography and onychoscopy.
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