Melanonychia - Causes, Symptoms and Treatment Tips

Nails discoloration of the toes due to repeated trauma to toenails, caused by ill-fitting shoes. Melanonychia creates a solitary dark band in the nail. This condition happens most commonly in Blacks and Asians. When it is seen in Caucasians, there is an increased chance of it representing a malignant process.

Symptoms of Melanonychia

Solitary longitudinal band is seen in the nail matrix or nail bed. It is hyperpigmented, or darker, than the normal proximate skin. It is oriented along the long axis of the finger.

Patients produce characteristic signs and symptoms; abnormalities of the cornea, cataracts and astigmatism along with sideways bent fingers, clubfoot, unusual neck bones, hip dislocation, poorly developed shoulder blades, or scoliosis. 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
• Scoliosis

Causes of Melanonychia

Melanonychia may imitate a mole or nevus involving the nail matrix, or origin of the nail. However, in may be caused by a melanoma, particularly in Caucasians. A biopsy may be necessary to determine the underlying cause.

Treatment of Melanonychia

Nail psoriasis, melanonychia striata, and onychomycosis are comparatively common nail disorders that have generated much research into their pathophysiology and treatment. Melanonychia needs to be evaluated by biopsy to authenticate if it is benign finding rather than a sign of subungual melanoma.

In the treatment of Melanonychia the hyperpigmentation of the skin and nails induced by chemotherapy is reversible and most commonly noticed with drugs like doxorubicin, cyclophosphamide and hydroxyurea. Melanonychia needs to be evaluated by biopsy to buttress if it is benign finding rather than a sign of subungual melanoma.

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