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Looking Beyond the Hutchinson Sign: A Retrospective Study of Clinical Factors Indicating the Presence and Invasiveness of Nail Unit Melanoma in Patients With Longitudinal Melanonychia

Authors
 Sang Gyun Lee  ;  Byung Ho Oh  ;  Kee Yang Chung  ;  Mi Ryung Roh 
Citation
 DERMATOLOGIC SURGERY, Vol.50(1) : 21-27, 2024-01 
Journal Title
DERMATOLOGIC SURGERY
ISSN
 1076-0512 
Issue Date
2024-01
MeSH
Diagnosis, Differential ; Humans ; Melanoma* / diagnosis ; Melanoma* / pathology ; Nail Diseases* / diagnosis ; Nail Diseases* / pathology ; Nails / pathology ; Retrospective Studies ; Skin Neoplasms* / diagnosis ; Skin Neoplasms* / pathology
Abstract
BACKGROUNDThe data underlying this article are available in the article.Longitudinal melanonychia (LM) presents a challenge because nail unit melanoma (NUM) must be considered as a differential diagnosis. Because nail matrix biopsy may result in nail dystrophy, it is important to distinguish NUM from LM.OBJECTIVETo provide evidence of previously reported clinical factors indicative of NUM in patients with LM.METHODSThis was a retrospective study of patients who presented with LM and had biopsy-confirmed NUM from 2005 to 2021. Benign LM was either confirmed by biopsy or considered benign if followed without the need for biopsy. Clinical factors associated with LM and NUM were compared by multivariate regression.RESULTSA total of 177 patients (97 LM and 80 NUM) were included. Multivariate regression showed that high band color intensity (p =.0031), variegation (p =.0005), nail plate splitting (p =.0017), Hutchinson sign (p =.0027), and band change (p =.001) correlated with malignancy. Nail plate splitting was associated with Breslow thickness.CONCLUSIONMalignancy should be suspected and biopsy performed in patients with LM and high band color intensity, variegation, nail plate splitting, Hutchinson sign, and band change. © 2024 Lippincott Williams and Wilkins. All rights reserved.
Full Text
https://journals.lww.com/dermatologicsurgery/fulltext/2024/01000/looking_beyond_the_hutchinson_sign__a.5.aspx
DOI
10.1097/DSS.0000000000003982
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Dermatology (피부과학교실) > 1. Journal Papers
Yonsei Authors
Roh, Mi Ryung(노미령) ORCID logo https://orcid.org/0000-0002-6285-2490
Oh, Byung Ho(오병호) ORCID logo https://orcid.org/0000-0001-9575-5665
Chung, Kee Yang(정기양) ORCID logo https://orcid.org/0000-0003-3257-0297
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/198610
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