Melanonychia (longitudinal brown streaks) may be seen as a normal variant in black-skinned patients. In a white patient it may reflect an underlying subungual melanoma, especially if the pigmentation progresses proximally onto the nail fold ('Hutchinson's sign').
Longitudinal Melanonychia, also known as Melanonychia Striata results from deposition of melanin in the nail plate from a variety of causes.
This longitudinal condition is paradoxical as increased skin pigmentation is common in the latter disease. In children, this can be caused by antibiotics, chemotherapeutic agents or other drugs as consequence of onychomycosis, infections, pseudomonas, psoriasis or other skin diseases.
Symptoms of Melanonychia
Some of the common symptoms of Melanonychia are as follows:
- Pain may occur in the nail
- Abnormalities of the cornea
- Cataracts and astigmatism along with sideways bent fingers
- Unusual neck bones
- Poorly developed shoulder blades
- Change in the color of nail may occur
- Nail become yellow in color
- Thickening or crumbling of the nail
Treatment of Melanonychia
In the treatment of Longitudinal Melanonychia the hyperpigmentation of the skin and nails induced by chemotherapy is reversible and most commonly seen with drugs like doxorubicin, cyclophosphamide and hydroxyurea.
Longitudinal Melanonychia needs to be evaluated by biopsy to corroborate if it is benign finding rather than a sign of subungual melanoma.
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