Nails

Vertical Nail Bands

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Vertical Nail Bands, Longitudinal Melanonychia, Longitudinal Brown Stripes in Nail

  • Epidemiology
  1. Normal variant in 90% of black patients
  2. Uncommon in lighter skinned patients
  • Signs
  1. Hyperpigmented longitudinal band
  2. May involve entire length of nail and affect one or multiple nails
  • Differential Diagnosis
  1. See Melanonychia
  2. See Nail Longitudinal Band
  3. See Nail Splinter Hemorrhage
  4. Subungual Melanoma (50% of Melanomas in dark skinned patients)
    1. Critical to distinguish from the benign Vertical Nail Bands
  • Evaluation
  1. Biopsy suspicious Longitudinal Melanonychia