II. Epidemiology

  1. Normal variant in 90% of black patients
  2. Uncommon in lighter skinned patients

III. Signs

  1. Hyperpigmented longitudinal band
  2. May involve entire length of nail and affect one or multiple nails

IV. Differential Diagnosis

  1. See Melanonychia
  2. See Nail Longitudinal Band
  3. Subungual Melanoma (50% of Melanomas in dark skinned patients)
    1. Critical to distinguish from the benign Vertical Nail Bands

V. Evaluation

  1. Biopsy suspicious Longitudinal Melanonychia

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