Melanonychia is a disorder of nail and is
characterized by the presence of a pigmented stripe, tan, brown, or black within the length of the nail bed and occurs most frequently in black and dark skinned individuals as well as women of any race. Melanonychia can occur in two forms - Longitudinal and
Longitudinal melanonychia is most worrisome when there is a solitary, dark, broad longitudinal band with pigment extending over the proximal nail fold (Hutchinson's sign.
Melanonychia may reflect a mole or nevus involving the nail matrix, or origin of the nail and mostly seen in black and asians.
Longitudinal Melanonychia needs to be evaluated by biopsy to corroborate if it is benign finding rather than a sign of subungual melanoma.
Fungal infection can be considered as the cause of this disorder but it must be differentiated from the Melanonychia caused by melanocytic lesions in people with subungual malignant melanoma, especially if noted in a single nail, and is associated with scleroderma in rare cases.
When it is seen in Caucasians, there is an increased chance of it representing a malignant process.
Some of the common symptoms of Melanonychia are as follows:
- Pain may occur in the nail
- Abnormalities of the cornea
- Cataracts and astigmatism along with sideways bent fingers
- Unusual neck bones
- Poorly developed shoulder blades
- Change in the color of nail may occur
- Nail become yellow in color
- Thickening or crumbling of the nail
In the treatment of Longitudinal Melanonychia the hyperpigmentation of the skin and nails induced by chemotherapy is reversible and most commonly seen with drugs like doxorubicin, cyclophosphamide and hydroxyurea.
Homeopathic remedies can cure this problem, though may be prescribed by a licensed certified homeopath only.
Nail psoriasis, melanonychia striata, and onychomycosis are relatively common nail disorders that have generated much research into their pathophysiology and treatment.