All About Melanonychia

Introduction

Nails grow, and often we cut them. While doing so, if we come across any stripes or lines of brown or black, we should not neglect them. The lines on the nails may be due to a natural occurrence, or due to trauma, or they may indicate other issues present in the body. The colored lines on the nails should not be ignored, especially when they are painful, bleeding, or occur without reason.

What Is Melanonychia?

Melanonychia is related to the lines present on the nail plate. These lines are either brown or black. The causes may be different for these lines. They may also express an underlying condition in the body. Other names for this condition are melanonychia striata and longitudinal melanonychia.

Melanonychia may involve one nail or many. These lines may be present naturally among dark-complexioned people. They may be seen on fingernails or toenails. Melanonychia should not be ignored, as it may indicate a serious underlying condition.

What Does Melanonychia Look Like?

The look of melanonychia depends on its cause. It looks like either longitudinal, transverse, or diffuse. The symptoms of melanonychia include:

1. Longitudinal Melanonychia: These are straight lines throughout the nail from the nail bed to the tip. They are either brown, black, or grey.

2. Transverse Melanonychia: These are lines passing from one side of the nail to the other side. They appear like bands.

3. Diffuse Melanonychia: Melanonychia is spread throughout the nail. The nail completely turns black.

What Are the Types of Melanonychia?

Melanonychia is caused by melanocytes. These are the cells that produce melanin. It is a dark brown pigment. Melanocytes are present in nails, but they are dormant. Hence, the nails appear translucent.

Melanonychia can occur in two ways.

1. Melanocytic Activation: In this type of melanonychia, the melanocytes get activated to produce melanin. The number of melanocytes remains the same.
2. Melanocytic Proliferation: In this type, the number of melanocytes are increased in the nail. The growth of melanocytes may be either cancerous or noncancerous.

What Causes Melanonychia?

The causes may be different for the two types of melanonychia. The causes of melanocytic activation include:

1. Races: Melanonychia may be naturally present among a few races, like African Americans, Indians, Japanese, and Hispanics. These appear as multiple bands that are straight and run from the nail bed to the nail tip. This type of melanonychia can be observed in fingernails. As the age increases, the width of the band also increases.

2. Pregnancy: During pregnancy, along with skin hyperpigmentation, the nails may also get hyperpigmented. Sometimes it may resolve on its own after pregnancy.

3. Infections: Melanonychia may be linked with many infections, such as bacterial, viral, or fungal infections.

4. Inflammation: Melanonychia may be caused by inflammation of the skin due to diseases. It may also be caused by inflammation of the shoe bites.

5. Medicines: Certain medicines, like chemotherapy, medicines used in treating HIV, and some medicines related to malaria, can cause melanonychia.

6. Nutrition: Lack of nutrients such as proteins, vitamin D, and vitamin B12 can cause melanonychia.

7. Tumors: Tumors, either benign or malignant, like basal cell carcinoma, can cause melanonychia.

8. Systemic Diseases: Melanonychia caused by systemic diseases is rare. If it occurs, it may be due to endocrine disorders.

The causes of melanocytic proliferation include:

• Benign causes are lentigo (flat pigmented areas of the skin) and nevi (moles).

• Melanoma is the most serious cause of melanonychia. This type of melanonychia is found to be dangerous.

Who Is More Likely to Get Melanonychia?

Melanonychia can affect anyone of any age and sex. It may also affect individuals with infections of bacteria, viruses, or fungi. It was noted that people who work in water and wet environments are more prone to bacterial melanonychia. Individuals who are involved in activities that cause trauma or friction to the nail plate may develop melanonychia. A study has found that trauma is the third most common cause of melanonychia.

How Is Melanonychia Diagnosed?

Melanonychia can be diagnosed by doing the following:

• Medical history and examination are done to know about melanonychia. With this, healthcare providers identify how many fingers are affected and what the pattern and color of the melanonychia are.

• A dermatoscope is used to know further. The affected nail is examined under a microscope. This procedure is called an onychoscopy.

• Closer examination is required to know whether the condition is benign or malignant.

• A biopsy has to be done to confirm the diagnosis of melanonychia. A part of the nail is taken and subjected to analysis of the cells of the streaks.

What Are the Treatment Options for Melanonychia?

The treatment of melanonychia depends on the cause. If the melanonychia is benign, it doesn't need treatment. If the cause is medication, then the medication has to be stopped. In the same manner, the cause should be addressed.

In case of cancerous melenonychia, the cancerous area should be removed. In such cases, a part or the whole nail will be removed. Sometimes, a finger or a toe that has the tumor may have to be removed.

What Are the Complications of Melanonychia?

The complications of Melanonychia depend on the cause. If melanonychia is cancerous, it may spread to other parts of the body, which may lead to health issues. In some cases, the nail may become deformed, which is bothersome for an affected individual.

Can Melanonychia Be Prevented?

Preventing melanonychia is not always feasible. The following steps may be taken to prevent trauma to nails. These include:

• Stop biting your nails.

• Nails should be kept clean and trimmed.

• Hands should be protected during activities, such as while working with tools, chemicals, and doing household work.

• Shoes with a good fit should be used to avoid damage to toenails.

Conclusion

Nails are a very small part of the body. Dark lines on the nails are called melanonychia. These have various causes. As melanonychia may be cancerous or non-cancerous, it should be dealt with carefully. Non-cancerous melanonychia doesn't need any treatment, but cancerous melanonychia needs to be removed. These are difficult to identify as they are similar to the causes of benign melanonychia. Hence, any melenonychia should be subjected to biopsy to identify the cancerous melanonychia early.

Key Takeaway From iCliniq

Though the nail is a small part of the body, it should not be neglected when it is seen with a black line on it. It may appear as a simple problem, but sometimes it may also be a cancerous one. Hence, it is important to know melanonychia in detail. For more details, you can contact us at icliniq.com.