소아에 발생한 선상 흑색손발톱의 임상적 고찰 (Clinical Manifestations of Longitudinal Melanonychia in Childhood)

서지정보

· 발행기관 : 대한피부과학회
· 수록지 정보 : 대한피부과학회지 / 54권 / 3호 / 167 ~ 177페이지
· 저자명 : 최윤선, 김진용, 최미라, 조광현

초록

Background: Longitudinal melanonychia is characterized by pigmented bands on the nail plate. It is not unusual to encounter pediatric melanonychia patients in the dermatologic clinic.
Objective: To assess the clinical manifestations of melanonychia in childhood in Korea, we reviewed the pediatric patient registry of a tertiary referral hospital in Korea.
Methods: Patients under fifteen years of age with longitudinal melanonychia referred between January, 2001, and March, 2015, were enrolled in the study. All patients had clinical as well as photo records. Clinical characteristics including age, sex, location, disease duration, width and color of pigmentation, morphological change over time, underlying disease, and dermoscopic images or biopsy findings were evaluated where available.
Results: A total of 92 patients had 158 pigmented nails, with more than one melanonychia identified in 14 patients.
The patient sample included 43 male and 49 female patients with an average age of 6.1 years at diagnosis. A follow-up examination was performed for 132 nails in 80 patients with a mean period of 27.8 months and morphological changes were identified in 61 nails. Changes included remission or aggravation of pigmentation. In 48% and 17% of patients, nail plate dystrophy and Hutchinson’s sign were observed, respectively. Dermoscopic image analysis was available for 79 nails. A nail biopsy was performed for 8 nails and none showed evidence of malignant melanoma.
Conclusion: Pediatric longitudinal melanonychia generally presents a benign nature despite overt morphological changes, diffuse pigmentation, or Hutchinson’s sign. Characteristically, melanonychia in childhood is frequently accompanied by nail dystrophy. Based on clinical reference of our study, aggressive nail biopsy may not be routinely necessary in pediatric melanonychia.

영어초록

Background: Longitudinal melanonychia is characterized by pigmented bands on the nail plate. It is not unusual to encounter pediatric melanonychia patients in the dermatologic clinic.
Objective: To assess the clinical manifestations of melanonychia in childhood in Korea, we reviewed the pediatric patient registry of a tertiary referral hospital in Korea.
Methods: Patients under fifteen years of age with longitudinal melanonychia referred between January, 2001, and March, 2015, were enrolled in the study. All patients had clinical as well as photo records. Clinical characteristics including age, sex, location, disease duration, width and color of pigmentation, morphological change over time, underlying disease, and dermoscopic images or biopsy findings were evaluated where available.
Results: A total of 92 patients had 158 pigmented nails, with more than one melanonychia identified in 14 patients.
The patient sample included 43 male and 49 female patients with an average age of 6.1 years at diagnosis. A follow-up examination was performed for 132 nails in 80 patients with a mean period of 27.8 months and morphological changes were identified in 61 nails. Changes included remission or aggravation of pigmentation. In 48% and 17% of patients, nail plate dystrophy and Hutchinson’s sign were observed, respectively. Dermoscopic image analysis was available for 79 nails. A nail biopsy was performed for 8 nails and none showed evidence of malignant melanoma.
Conclusion: Pediatric longitudinal melanonychia generally presents a benign nature despite overt morphological changes, diffuse pigmentation, or Hutchinson’s sign. Characteristically, melanonychia in childhood is frequently accompanied by nail dystrophy. Based on clinical reference of our study, aggressive nail biopsy may not be routinely necessary in pediatric melanonychia.

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