A survey-based study of management of longitudinal melanonychia amongst attending and resident dermatologists

To the Editor: Subungual melanoma (SM) represents 0.7% to 3.5% of melanoma cases, but often carries a worse prognosis than similarly staged cutaneous melanomas.1-3 While longitudinal melanonychia (LM), a brown-black band of the nail plate, is the most common presenting sign of SM (2/3 of cases), it is not specific for SM.4 In fact, in 1 study, only 6.8% cases of LM showed histologic evidence of SM, with the remaining cases benign etiologies, including subungual hematoma, nail matrix nevus, trauma, nail apparatus lentigo, and melanocytic activation.

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