share on Pinterest1207219380 Holding Touching hands Asian senior or elderly old lady woman patient with love, care, helping, encourage and empathy at nursing hospital ward : healthy strong medical concept. Sasirin Pamai/EyeEm/Getty Images Melanonychia refers to the stain of the nail plate on a feel or toe. The stain is normally brown or bootleg, and it can occur in one or more digits. The complete plate is normally translucent because of a lack of melanin, the kernel responsible for skin pigmentation. however, under some circumstances, melanin can cause nail discoloration, leading to melanonychia.
There are three independent types of melanonychia :
- Longitudinal melanonychia: Also called melanonychia striata, this is the most common form of melanonychia. It presents as a long band along the length of the nail plate.
- Diffuse or total melanonychia: This form causes discoloration over the entire nail plate.
- Transverse melanonychia: This type appears as a band of color that runs along the width of the nail plate.
Melanocytes are the cells that produce melanin. If they increase in count or produce more melanin than common, this can lead to melanonychia. There are two ways in which this can happen :
In melanocyte activation, there is no change in the issue of melanocytes, but these cells increase the production and distribution of melanin in the collar .
Melanocyte hyperplasia refers to an increased count of melanocytes in the nail. In some cases, it can be harmless, or benign, but in others, it can be malignant. There are many possible causes of melanonychia via melanocytic activation, equally well as factors that can make it more probable. Causes and gamble factors include :
- Racial differences: Melanonychia is more prevalent in people with dark skin. For example, it affects up to 20% of Japanese people and 77–100% of African American people. In comparison, only 1% of white people will experience it.
- Pregnancy: Longitudinal melanonychia may happen during pregnancy, when it may affect several fingernails or toenails.
- Fungal infection: Certain fungi can produce melanin that becomes incorporated into the nail plate. This occurs more frequently in males than in females and involves the toenails.
- Bacterial infection: People with a weakened immune system can be more at risk of infection with bacteria that can cause melanonychia, such as Pseudomonas aeruginosa.
- Viral infection: People living with HIV may develop longitudinal and transverse bands in their fingernails and toenails.
- Skin conditions: Inflammatory skin conditions, such as psoriasis, lichen planus, and amyloidosis, can lead to melanocyte activation and melanonychia.
- Trauma: Nail biting, pulling, chewing, and friction can lead to diffuse or longitudinal bands.
- Tumors: Both benign and malignant tumors, such as Bowen’s disease or squamous cell carcinoma, can lead to melanocytic activation.
- Systemic diseases: People with diseases such as Addison’s disease and Cushing’s syndrome may develop melanonychia in several fingernails or toenails. The condition usually presents as diffuse melanonychia or in the form of multiple streaks.
- Drugs: Drugs typically cause transverse melanonychia in multiple nails.
- Medical treatment-related: People who are receiving chemotherapy or have undergone X-rays may experience melanonychia. The length of exposure to the agent may determine whether or not melanonychia affects a person.
The possible causes of melanonychia via melanocytic hyperplasia admit :
- Nail matrix nevus: This benign condition presents as a light brown to black longitudinal band, about 3–5 millimeters (mm) wide. It is the most common cause of melanonychia in children. The presence of melanocyte “nests,” or collections of cells, distinguishes this condition.
- Lentigo: This benign condition occurs without the presence of melanocyte nests but with similar-sized 3–5 mm bands. It is more common in adults than in children.
- Nail unit melanoma (NUM): This condition is rare but malignant. Asian countries, including Japan, China, and Korea, report a higher incidence. It tends to affect the big toes, thumbs, and middle fingers.
Melanonychia can affect individuals of all sexes and ages. however, there is an increase incidence of melanonychia in People of Color.
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Environments that expose people to bacteria, viruses, or fungi besides increase melanonychia risk. For case, people whose work involves prolonged or repeated touch with water or besotted substances are more likely to develop bacterial melanonychia. People who participate in activities that can cause friction or trauma to the smash plate may develop melanonychia. A 2016 analyze involving 275 korean people with melanonychia found that trauma was one of the three most common causes .
The discussion options for melanonychia will depend on the basal induce. If the cause is benign, the individual may not need treatment. Some cases of melanonychia may fade after addressing the campaign. For example, if drugs are the lawsuit, melanonychia should fade within 6–8 weeks of stopping the discussion. Where the causal agent is malignant, such as in NUM, a repair may suggest operating room. A surgeon may remove the entire nail down unit or amputate the end of the toe or finger.
A doctor will normally diagnose the cause of melanonychia by taking a medical history and examining the nails. They will determine the count of affect digits and observe the pattern and color of the melanonychia. In some cases, the repair may require far tests to aid diagnosis. They may examine the involve nail under a particular type of microscope called a dermatoscope. This process is called onychoscopy. Onychoscopy can help differentiate melanonychia from other conditions. For example, a splinter shed blood presents as a red-brown longitudinal streak under the nail plate and looks like a wood sliver. Onychoscopy would help distinguish this from melanonychia. similarly, a closer examination can help the doctor determine whether the condition is benign or malignant. With NUM, the band or streak on the feign nail down may change by :
- getting wider over weeks to months
- becoming more irregular in color
- extending and affecting the skin bordering the nail
- causing the nail plate to deform and change in shape
The repair may order a biopsy for far ratification. This procedure involves removing a part of the nail and looking at the cells of the mottle more closely. This analysis remains the gold standard for an accurate diagnosis .
The complications of melanonychia will depend on the implicit in lawsuit. For example, if the melanonychia is malignant, it could spread and affect other parts of the body, leading to dangerous health issues. Some causes of melanonychia can lead to the nail becoming deformed, which people may find concerning or annoying.
Melanonychia is a pinpoint pigmentation condition that has several implicit in causes. It occurs because of an increase in the number of melanocytes in the nail down home plate or an increase in melanin production. An individual may not need treatment unless the melanonychia is potentially malignant. If a person suspects that they have melanonychia, they should seek aesculapian advice to ensure an accurate diagnosis and avoid the risk of complications .