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Derm News: 2007.25(6)

Diagnosis and management of nail pigmentations

Journal of the American Academy of Dermatology, 56(5):835-847
Ralph Peter Braun, Robert Baran, Frederique Anne Le Gal, Stephane Dalle, Sandra Ronger, Roberta Pandolfi, Olivier Gaide, Lars Einar French, Paul Laugier, Jean Hilaire Saurat, Ashfaq Ahmed Marghoob, Luc Thomas

Longitudinal pigmentation of the nail is very common. The differential diagnosis varies from subungual hematoma, to a fungal infection, to a melanocytic lesion (lentigo, nevus melanoma, etc.) to others. Often, dermatologists do not feel at ease with these pathologies and management is often not clear. In many cases, a biopsy is not helpful because an inadequate technique was chosen. The use of noninvasive techniques such as dermoscopy has been described to be useful for the preoperative evaluation and the management decision. Using these technique, one will be able to reduce the number of unnecessary surgeries and to choose the most adequate biopsy technique. In this article, we will review the management, including diagnosis as well as differential diagnosis of nail pigmentations and propose a new algorithm for the non invasive diagnosis of nail pigmentation.

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The Derm News service provided by the Editorial Consultants of Skin Therapy Letter© and its founding editor Dr. Stuart Maddin.