Melanonychia in children: on the way to recommendations for management tactics

The experience of clinical and instrumental diagnosis of 60 cases of nail plate pigmentation in children is presented in this paper and for the first time in the domestic literature. Lack of reliable information on external manifestations and management tactics of longitudinal linear melanonychia in children, assumption of its possible role in the development of nail melanoma, as well as the difficulty of carrying out a diagnostic biopsy of the nail plate matrix in the child make the article extremely relevant. The possibility of detecting atypical clinical manifestations of melanonychia in children, such as total lesion of the entire nail plate, formation of nonhomogeneous coloring of the pigment strip and/or spontaneous violation of the nail integrity is shown, detailed clinical and dermatoscopic illustrations and optimal technique of surgical intervention are presented. None of the 9 children who underwent diagnostic biopsy of the nail plate matrix was found to have a malignant tumor in histological examination. Based on the literature review and own practical experience analysis, it was concluded that it is impossible to extrapolate the characteristics of nail melanoma in adult patients to the pediatric cohort and reinterpretation of the indications for surgical intervention was proposed.