• Users Online: 1133
  • Print this page
  • Email this page
Year : 2020  |  Volume : 11  |  Issue : 2  |  Page : 171-176

Intra-operative dermoscopy in assessment of melanonychia and as a guide for biopsy

1 Department of Dermatology and Venereology and Leprosy, ESI-PGIMSR Hospital, Basaidarapur, Delhi, India
2 Department of Dermatology and Venereology and Leprosy, NDMC and Hindu Rao Hospital, Delhi, India
3 Department of Pathology, ESI-PGIMSR Hospital, Basaidarapur, Delhi, India

Correspondence Address:
Ishmeet Kaur
Department of Dermatology and Venereology and Leprosy, ESI-PGIMSR Hospital, Basaidarapur, Delhi
Login to access the Email id

Source of Support: None, Conflict of Interest: None

DOI: 10.4103/idoj.IDOJ_94_19

Rights and Permissions

Background and Aims: Melanonychia can be a manifestation of benign or malignant pathology and often poses a diagnostic challenge on clinical examination. Even with distinguishing dermoscopic features (nail plate), it can be quite difficult to determine the nature of pigmentation as complete assessment of nail bed and matrix is still not possible. Intraoperative dermoscopy (IOD) can serve as a useful tool to appreciate the bed and matrix changes. The aim here is to study the intraoperative dermoscopic features in patients with melanonychia and correlate with histopathology. Methods: 20 consecutive patients with melanonychia were recruited. Inclusion criteria was melanonychia of sudden onset, progressive nature, irregular width/color/symmetry on dermoscopy, positive Hutchinson sign, solitary nail involvement or associated nail dystrophy. Preoperative dermoscopy was performed and recorded. Patients were planned for nail matrix biopsy, during which IOD was performed over nail matrix and bed after removal of the nail plate. Images were recorded and analyzed and correlated with the histopathology. Results: Out of 20 patients, 12 were females and 8 males. On IOD-histopathological correlation, 2 patients were found to have melanoma of the nail unit, 5had nail lichen planus, 9 had benign melanocytic nevi, and 4 had fungal melanonychia. IOD revealed fine, parallel and regular lines of pigmentation localized to proximal nail bed and matrix in all patients with benign melanonychia, while dark thick bands with irregular borders, dots, globules, streaks and structureless areas in the two patients with melanoma. Fungal melanonychia revealed an unremarkable nail bed and matrix on IOD. Conclusion: Intraoperative dermoscopycan help in determining the nature of melanonychia and obviate the need to perform biopsy in certain cases. It can also aid in delineating the most suitable site for biopsy, along with grossly assessing the extent of involvement in case of malignancy.

Print this article     Email this article
 Next article
 Previous article
 Table of Contents

 Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
 Related articles
 Citation Manager
 Access Statistics
 Reader Comments
 Email Alert *
 Add to My List *
 * Requires registration (Free)

 Article Access Statistics
    PDF Downloaded428    
    Comments [Add]    

Recommend this journal