Longitudinal melanonychia: detection and management of nail melanoma

Hand Surg. 2013;18(1):133-9. doi: 10.1142/S0218810413300015.


Malignant melanoma of the nail confers a higher mortality rate compared to other cutaneous melanomas, which is often attributable to delayed diagnosis. Two-thirds of nail melanomas present as longitudinal melanonychia (LM), longitudinally-oriented brown-black bands of pigment in the nail plate. This article delineates the appropriate clinical approach toward evaluation and management of a patient with longitudinal melanonychia, which includes determining risk factors for melanoma, recognizing scenarios in which biopsy is indicated, selecting the appropriate biopsy technique, and managing a patient in whom the diagnosis of nail melanoma has been made.

Publication types

  • Review

MeSH terms

  • Biopsy
  • Diagnosis, Differential
  • Humans
  • Melanoma / diagnosis*
  • Melanoma / surgery*
  • Nail Diseases / diagnosis*
  • Nail Diseases / surgery*
  • Nails / pathology
  • Nails / surgery
  • Orthopedic Procedures / methods*
  • Skin Neoplasms / diagnosis*
  • Skin Neoplasms / surgery*