Abcd de lunares ungeales

Published Journal Scan March 01, 2019

Clinical and Dermoscopic Features of Longitudinal Melanonychia, ABCDEF Criteria, and Risk of Malignancy

Journal of the American Academy of Dermatology

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This study identified the clinical and dermoscopic features that distinguish histopathologically diagnosed subungual melanoma from benign longitudinal melanonychia and evaluated the validity of the ABCDEF criteria among patients on whom a biopsy was performed. Of the 84 nail biopsies, there were 8 cases of subungual melanoma. Patients with melanoma were younger (P= .011), had a longer duration melanonychia (P=.017), and presented with a wider band (P=.002) and greater width percentage (P<.001) than patients with benign conditions. The number of ABCDEF criteria met were similar between the groups.

Abstract

Given that clinical and dermoscopic signs were not consistent, the authors recommend a biopsy in cases with concerning longitudinal melanonychia, especially in those with width percentage higher than 40%.
– InYoung Kim, MD, PhD

BACKGROUND
Longitudinal melanonychia (LM) is a common finding in clinical practice; however, it has a broad differential diagnosis, including subungual melanoma (SUM), which can be difficult to distinguish clinically from benign conditions.
OBJECTIVE
To identify clinical and dermoscopic features that distinguish histopathologically diagnosed SUM from benign LM and to evaluate the validity of the ABCDEF criteria among patients on whom a biopsy was performed.
METHODS
Retrospective cohort study of consecutive patients who underwent nail matrix biopsy for LM at a single center from January 2011 to November 2017.
RESULTS
A total of 84 cases in which biopsy was performed (8 cases of SUM and 76 benign) were included in the analysis. The patients with SUM were younger (P = .011), had their melanonychia longer (P = .017), and presented with a wider band (P = .002) and greater width percentage (P < .001) than patients with benign LM did. The number of ABCDEF criteria met did not differ between the groups.
LIMITATIONS
Retrospective single-center study; patients who did not undergo biopsy could not be studied.
CONCLUSIONS
In the cases of LM in which biopsy was performed, SUM usually presented with a wider band and greater width percentage than benign LM did. The number of ABCDEF criteria met was not different between the groups. Because many of the clinical and dermoscopic signs were less consistent, biopsy should be performed in cases with any concerning band, especially in those with width percentage higher than 40%.

https://dx.doi.org/10.1016/j.jaad.2018.08.033

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Benjamin Hidalgo-Matlock
Skin Care Physicians of Costa Rica

Clinica Victoria en San Pedro: 4000-1054
Momentum Escazu: 2101-9574

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