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"Dermoscopic and clinical features of congenital or congenital-type nail matrix nevi: a multicenter prospective cohort study by the International Dermoscopy Society".
Journal of the American Academy of Dermatology 2022 January 30
BACKGROUND: Congenital nail matrix nevi (NMN) are difficult to diagnose because they feature clinical characteristics suggestive of adult subungual melanoma (SUM). Nail matrix biopsy is difficult to perform, especially in children.
OBJECTIVE: To describe the initial clinical and dermoscopic features of NMN appearing at birth (congenital) or after birth but before the age of five (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 NMN. Congenital and congenital-type NMN predominantly displayed an irregular pattern of longitudinal micro-lines (n= 146, 64%), reminiscent of SUM 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 displayed more frequently a periungual pigmentation (P = .029) and Hutchinson's sign (P = .027) than congenital-type NMN.
LIMITATIONS: Lack of systematic biopsy-proven diagnosis and heterogeneity of clinical and dermoscopic photographs.
CONCLUSION: Congenital and congenital-type NMN showed worrisome clinical and dermoscopic features similar to those observed in adulthood SUM. The distal fibrillar ("brush-like") pattern is a suggestive feature of congenital and congenital-type NMN.
OBJECTIVE: To describe the initial clinical and dermoscopic features of NMN appearing at birth (congenital) or after birth but before the age of five (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 NMN. Congenital and congenital-type NMN predominantly displayed an irregular pattern of longitudinal micro-lines (n= 146, 64%), reminiscent of SUM 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 displayed more frequently a periungual pigmentation (P = .029) and Hutchinson's sign (P = .027) than congenital-type NMN.
LIMITATIONS: Lack of systematic biopsy-proven diagnosis and heterogeneity of clinical and dermoscopic photographs.
CONCLUSION: Congenital and congenital-type NMN showed worrisome clinical and dermoscopic features similar to those observed in adulthood SUM. The distal fibrillar ("brush-like") pattern is a suggestive feature of congenital and congenital-type NMN.
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