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Multicenter Study
. 2022 Sep;87(3):551-558.
doi: 10.1016/j.jaad.2022.01.028. Epub 2022 Jan 29.

Dermatoscopic and clinical features of congenital or congenital-type nail matrix nevi: A multicenter prospective cohort study by the International Dermoscopy Society

Félix Pham  1 , Amélie Boespflug  1 , Gérard Duru  2 , Alice Phan  3 , Nicolas Poulalhon  4 , Laura Weiler  4 , Masaru Tanaka  5 , Aimilios Lallas  6 , Dai Ogata  7 , Anne Céline Davaine  8 , Philippe Bahadoran  9 , Xavier Balguerie  10 , Grażyna Kamińska-Winciorek  11 , Isabelle Tromme  12 , Osvaldo Correia  13 , Moon-Bum Kim  14 , Ashfaq A Marghoob  15 , Linda Martin  16 , Pascale Guitera  16 , Mariame Meziane  17 , Juliette Miquel  18 , Je-Ho Mun  19 , Giuseppe Argenziano  20 , Didier Bessis  21 , Johnny Bourke  22 , Zeljko Mijuskovic  23 , Christine Chiaverini  24 , Cloé Corven-Benoit  25 , Catherine Droitcourt  26 , François Skowron  27 , Myriam Marque  28 , Iris Zalaudek  29 , Cliff Rosendahl  30 , David Moreno-Ramirez  31 , Pierre Vabres  32 , Holger Haenssle  33 , Josep Malvehy  34 , Susana Puig  34 , Caroline Robert  35 , Thomas R Schopf  36 , Alon Scope  37 , Stéphane Dalle  1 , Luc Thomas  38
Affiliations
Multicenter Study

Dermatoscopic and clinical features of congenital or congenital-type nail matrix nevi: A multicenter prospective cohort study by the International Dermoscopy Society

Félix Pham et al. J Am Acad Dermatol. 2022 Sep.

Abstract

Background: Congenital nail matrix nevi (NMN) are difficult to diagnose because they feature clinical characteristics suggestive of adult subungual melanoma. Nail matrix biopsy is difficult to perform, especially in children.

Objective: To describe the initial clinical and dermatoscopic features of NMN appearing at birth (congenital) or after birth but before the age of 5 years (congenital-type).

Methods: We conducted a prospective, international, and consecutive data collection in 102 hospitals or private medical offices across 30 countries from 2009 to 2019.

Results: There were 69 congenital and 161 congenital-type NMNs. Congenital and congenital-type NMN predominantly displayed an irregular pattern of longitudinal microlines (n = 146, 64%), reminiscent of subungual melanoma in adults. The distal fibrillar ("brush-like") pattern, present in 63 patients (27.8%), was more frequently encountered in congenital NMN than in congenital-type NMN (P = .012). Moreover, congenital NMN more frequently displayed a periungual pigmentation (P = .029) and Hutchinson's sign (P = .027) than did congenital-type NMN.

Limitations: Lack of systematic biopsy-proven diagnosis and heterogeneity of clinical and dermatoscopic photographs.

Conclusion: Congenital and congenital-type NMN showed worrisome clinical and dermatoscopic features similar to those observed in adulthood subungual melanoma. The distal fibrillar ("brush-like") pattern is a suggestive feature of congenital and congenital-type NMN.

Keywords: children; congenital; congenital nail matrix nevus; dermatoscopy; longitudinal melanonychia; melanonychia striata; nevus of the nail unit; pediatric; subungual melanoma.

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Conflict of interest statement

Conflicts of interest None disclosed.

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