Narrative review demonstrates that pediatric longitudinal melanonychia is predominantly benign, suggesting conservative longitudinal monitoring avoids unnecessary invasive nail surgeries.
Key Points
To synthesize current evidence on the diagnostic evaluation, natural history, and clinical management of longitudinal melanonychia in children.
Conducted a narrative review across PubMed for studies addressing pediatric melanonychia, nail matrix nevi, and subungual melanoma without publication date restrictions.
Identified and reviewed English-language articles and their reference lists focusing on clinical, dermoscopic, and histopathologic characteristics.
Clinical, dermoscopic, and histopathologic features of pediatric longitudinal melanonychia frequently overlap with adult melanoma criteria, yet the condition is overwhelmingly benign.
Pediatric nail matrix nevi exhibit a dynamic natural history, with documented evidence showing they can naturally progress or spontaneously regress over time.
Conservative serial observation using dermoscopy and photography is supported over routine biopsy, preserving surgery solely for cases exhibiting rapid progression or marked atypia.