Longitudinal erythronychia: suggestions for evaluation and management

J Am Acad Dermatol. 2011 Jan;64(1):167.e1-11. doi: 10.1016/j.jaad.2009.10.047. Epub 2010 Aug 14.


Longitudinal erythronychia is a frequent nail presentation with a limited differential diagnosis. This clinical entity may be divided into cases that involve one (localized) or multiple (polydactylous) nails. The different presentations have distinct differential diagnoses and workups yet often share a common pathogenesis. Localized longitudinal erythronychia most commonly represents onychopapilloma, yet malignancies may present identically. Therefore biopsy may be required. Polydactylous longitudinal erythronychia usually coincides with a regional or systemic cause. Occasionally, it may herald an important underlying disease. A thorough understanding of the pathogenesis, clinical presentations, and possible diagnoses is necessary for successful evaluation and management.

Publication types

  • Review

MeSH terms

  • Biopsy, Needle
  • Diagnosis, Differential
  • Female
  • Follow-Up Studies
  • Humans
  • Immunohistochemistry
  • Male
  • Nail Diseases / diagnosis
  • Nail Diseases / pathology*
  • Nail Diseases / surgery
  • Nails / pathology*
  • Nails / surgery
  • Papilloma / diagnosis
  • Papilloma / pathology*
  • Papilloma / surgery
  • Paraneoplastic Syndromes / diagnosis
  • Paraneoplastic Syndromes / pathology*
  • Skin Neoplasms / diagnosis
  • Skin Neoplasms / pathology*
  • Skin Neoplasms / surgery
  • Treatment Outcome