H.M. Cheng, P. Guitera
Introduction: Nail pigmentation often poses a diagnostic
challenge. When faced with an equivocal lesion, periodic
dermoscopic follow up is recommended.
However, the
optimal interval and duration for monitoring remains
unclear.
Method: 198 consecutive nail pigmented lesions from 182
patients were retrospectively analysed. 108 lesions from 93
patients underwent short-term digital monitoring SDDI of
the nail and were included in the study. Interval of SDDI
was 6 weeks, 3 months or both. Benign lesions were defined
as those which remained unchanged at 6–9 month monitoring,
at >12 month monitoring or those where patients did
not undergo any nail biopsy or develop a diagnosis of melanoma
on the pathology database.
Results: 11 biopsies were performed due to change. 5 were
found to be melanoma. 2/5 were detected at 6 weeks, and
3/5 were detected at 3 months. 1/3 and 2/5 lesions biopsied
at 6 weeks and 3 months respectively were benign. Of the
100 lesions unchanged at 3 months, all were found to be
benign. Significant and non-significant changes will be
reviewed in detail and the usefulness of monitoring in the
management of melanonychia will be discussed.