10.5826/dpc.1301a62
text/xml
2160-9381
2626
en
Francisco G.  Schreiber 
https://creativecommons.org/licenses/by-nc/4.0
Dermatology Practical & Conceptual
Longitudinal Melanonychia as the Only Sign of in Situ Squamous Cell Carcinoma
Text.Serial.Journal
https://dpcj.org/index.php/dpc
Image Letter
2023-01-31
2022-06-01
2023-01-31
2023-03-01
e2023062
Dermatol Pract Concept
Francisco G.  Schreiber 
2023/01/31
10.5826/dpc.1301a62
e2023062
Private practice, Resistencia, Chaco, Argentina
2160-9381
en
e2023062
Singal A and Bisherwal K, Melanonychia: Etiology, Diagnosis, and Treatment. Indian Dermatol Online J, 2020;11(1):1-11. DOI: 10.4103/idoj.IDOJ_167_19 PMID: 32055501
Longitudinal Melanonychia as the Only Sign of in Situ Squamous Cell Carcinoma
https://dpcj.org/index.php/dpc/article/download/2626/1926
          Longitudinal Melanonychia as the Only Sign
             of in Situ Squamous Cell Carcinoma
       José Alberto García-Lozano1, Gabriel Salerni2, Jesus Alberto Cardenas-de la Garza3,
                       María Rosa Perez4, Francisco Guillermo Schreiber4


1 Universidad Autónoma de Nuevo León, Departamento de Introducción a la Clínica, Facultad de Medicina y Hospital Universitario “Dr. José
  E. González’’, Monterrey, Nuevo León, Mexico
2 Dermatology Department, Hospital Provincial del Centenario de Rosario, Universidad Nacional de Rosario, Santa Fe, Argentina
3 Universidad Autónoma de Nuevo León, Servicio de Reumatología, Facultad de Medicina y Hospital Universitario “Dr. José E. González’’,
  Monterrey, Nuevo León, México
4 Private practice, Resistencia, Chaco, Argentina



Citation: García-Lozano JA, Salerni G, Cardenas-de la Garza JA, Perez MR, Schreiber FG. Longitudinal Melanonychia As The Only Sign
Of In Situ Squamous Cell Carcinoma. Dermatol Pract Concept. 2023;13(1):e2023062. DOI: https://doi.org/10.5826/dpc.1301a62
Accepted: August 28, 2022; Published: January 2023
Copyright: ©2023 García-Lozano et al. This is an open-access article distributed under the terms of the Creative Commons Attribution-
NonCommercial License (BY-NC-4.0), https://creativecommons.org/licenses/by-nc/4.0/, which permits unrestricted noncommercial use,
distribution, and reproduction in any medium, provided the original authors and source are credited.
Funding: None.
Competing Interests: None.
Authorship: All authors have contributed significantly to this publication.
Corresponding Author: José Alberto García-Lozano, MD, Universidad Autónoma de Nuevo León, Departamento de Introducción a la
Clínica, Facultad de Medicina y Hospital Universitario “Dr. José E. González’’, Monterrey, Nuevo León, México. Tel: 81 8329 4154
E-mail: dr.josealbertogarcia@gmail.com




Case Presentation                                                        with other common infectious or inflammatory nail dis-
                                                                         eases due to its multiple clinical presentations. Melanony-
A 39-year-old man was consulted because of a 2-year history              chia has always been a challenging sign for dermatologists.
of a pigmented lesion in his right thumbnail (Figure 1A). His            Longitudinal melanonychia is often associated with benign
personal history was remarkable for previous genital human               or malignant melanocytic proliferation, and nail unit mel-
papillomavirus (HPV) infection. Onychoscopy revealed a                   anoma (NUM) should always be ruled out [2]; therefore,
pigmented longitudinal melanonychia that affected the cuti-              dermoscopy of the nail apparatus (onychoscopy) is an in-
cle to the distal edge of the nail plate with no other signs or          dispensable tool in the evaluation of pigmented nail lesions.
symptoms (Figure 1B). Complete excision of the lesion with               Any unexplained melanonychia of a single digit in white-
narrow margins was performed because of a suspicion of                   skinned individuals should be biopsied to rule out NUM;
malignancy. Histological examination revealed in situ squa-              however, this case demonstrates that nail unit in situ SCC
mous cell carcinoma (SCC).                                               can also present exclusively as longitudinal melanonychia
                                                                         with no other deformity or periungual lesion and should
Teaching Point                                                           always be included in the differential diagnosis when longi-
                                                                         tudinal melanonychia is present.
SCC and in situ SCC are the most common malignant
tumors of the nail [1]. This disease is often misdiagnosed




Image Letter | Dermatol Pract Concept. 2023;13(1):e2023062                                                                              1
    Figure 1. (A) Clinical image of the pigmented lesion in the right thumb nail. (B) Onychoscopy of the lesion demonstrates a brown-
    dark, homogeneous, pigmented, longitudinal melanonychia. Hutchison and micro-Hutchinson signs absent.




References                                                             2. Singal A and Bisherwal K. Melanonychia: Etiology, Diagnosis,
                                                                          and Treatment. Indian Dermatol Online J. 2020;11(1):1-11.
1. Starace M, Alessandrini A, Dika E, Piraccini BM. Squa-                 DOI: 10.4103/idoj.IDOJ_167_19. PMID: 32055501. PMCID:
   mous cell carcinoma of the nail unit. Dermatol Pract Con-              PMC7001389.
   cept.   2018;8(3):238-244.  DOI:      10.5826/dpc.0803a17.
   PMID: 30116671. PMCID: PMC6092066.




2                                                                            Image Letter | Dermatol Pract Concept. 2023;13(1):e2023062
