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Journal of the American Academy of Dermatology
Volume 74, n° 6
pages 1121-1127 (juin 2016)
Doi : 10.1016/j.jaad.2015.12.039
accepted : 20 December 2015
Original Articles

Diagnostic criteria for and clinical review of melanonychia in Korean patients

Hyunju Jin, MD a, Jeong-Min Kim, MD a, Gun-Wook Kim, MD a, Margaret Song, MD a, Hoon-Soo Kim, MD a, Hyun-Chang Ko, MD a, Byung-Soo Kim, MD, PhD a, b, Moon-Bum Kim, MD, PhD a, b,
a Department of Dermatology, School of Medicine, Pusan National University Hospital, Busan, Korea 
b Biomedical Research Institute, Pusan National University Hospital, Busan, Korea 

Reprint requests: Moon-Bum Kim, MD, PhD, Department of Dermatology, Pusan National University Hospital, 179 Gudeok-ro, Seo-gu, Busan, 49241 Korea.Department of DermatologyPusan National University Hospital179 Gudeok-ro, Seo-guBusan49241Korea

Melanonychia may be the presenting sign of ungual melanoma. However, there are insufficient basic clinical data for melanonychia in Korean patients.


We sought to identify basic clinical data and devise a classification algorithm for melanonychia.


In all, 275 patients with melanonychia who visited our clinic from January 2002 to August 2014 were included in this study. We reviewed medical records, clinical and dermoscopic photographs, and histopathologic findings and we assessed demographics (eg, age); medical (eg, systemic diseases), family, and trauma (eg, nail biting) history; and physical findings (eg, affected number and site).


The 5 most common causes of melanonychia in Korean patients were subungual hemorrhage (29.1%), nail matrix nevus (21.8%), trauma-induced pigmentation (14.5%), nail apparatus lentigo (11.6%), and ethnic-type nail pigmentation (8.0%). Melanoma was diagnosed in 6.2% of patients. Ethnic-type nail pigmentation was commonly identified.


This is a retrospective study from a single center.


We propose a revised diagnostic algorithm for melanonychia to assist in the evaluation of this condition.

The full text of this article is available in PDF format.

Key words : algorithm, Korea, melanonychia, nail pigmentation, subungual hemorrhage, ungual melanoma

Abbreviations used : ETP, NAL, NMN

 Funding sources: None.
 Conflicts of interest: None declared.

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