A clinical, histopathologic, and outcome study of melanonychia striata in childhood

Chelsea Cooper, Nicoleta C. Arva, Christina Lee, Oriol Yélamos, Roxana Obregon, Lauren M. Sholl, Annette Wagner, Lisa Shen, Joan Guitart, Pedram Gerami*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

58 Scopus citations


Background The current literature suggests that approximately 5% to 10% of melanonychia striata cases in adults are the result of subungual melanoma. Objective We sought to evaluate the clinical and histopathologic features and to determine the outcomes and causes of melanonychia striata in a cohort of children. Methods We assessed 30 childhood cases of melanonychia striata for features typically associated with melanoma such as Hutchinson sign, width of the pigmented band, evolution, color, and nail dystrophy. We assessed the histopathology of lesional biopsy specimens, including melanocyte counts and suprabasal movement of melanocytes. Clinical follow-up information was reviewed when available. Results Histopathologic diagnoses included subungual lentigo in 20 cases, subungual nevus in 5 cases, and atypical melanocytic hyperplasia in 5 cases. Although a number of cases exhibited worrisome clinical or histopathologic features, none showed evidence of aggressive behavior or warranted a diagnosis of melanoma. Limitations The sample size and follow-up times are limited. Conclusions Melanonychia striata is typically associated with benign stable melanocytic proliferations in childhood. The overwhelming majority of cases can be managed conservatively. Biopsy is required in select cases.

Original languageEnglish (US)
Article number9982
Pages (from-to)773-779
Number of pages7
JournalJournal of the American Academy of Dermatology
Issue number5
StatePublished - May 1 2015


  • longitudinal melanonychia
  • melanonychia striata
  • subungual lentigo
  • subungual melanoma
  • subungual nevus

ASJC Scopus subject areas

  • Dermatology


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