宽度看起来超过了3mm，颜色也比较黑，可能要考虑甲母痣了。不知后来做了病理没，结果有么？

 谢谢各位老师精彩的讲解,学习了！

谢谢各位老师精彩的讲解，

 甲母质痣

学习了

甲母质痣是甲床出现的色素痣，最常见的症状就是整齐的甲黑线，偶可弥漫全甲下。

全身性因素：全身色素性疾病见于黑棘皮病、Addison病、Peutz-Jeghers综合征和维生素B12缺乏，库欣综合症行肾上腺切除术后，或为Laugier-Hunziker综合症。同时，合并甲色素沉着，甲母质痣。

局部诱因：局部诱发因素有外伤，真菌感染，湿疹样改变，甲下出血。其他因素可见于药物（化疗药物、抗疟药、米诺环素或金制剂）诱导。

较大者可发生恶变为黑色素瘤。

请见国外参考文献。

1. J Am Acad Dermatol. 1996 May;34(5 Pt 1):765-71.

Nail matrix nevi: a clinical and histopathologic study of twenty-two patients.

Tosti A, Baran R, Piraccini BM, Cameli N, Fanti PA.

Abstract

BACKGROUND:

Because most dermatologists do not regularly perform biopsies of longitudinal melanonychia, even when the pigmentation presents as a single band, the true prevalence of nail matrix nevi is unknown.

OBJECTIVE:

Our purpose was to determine the prevalence of nail matrix nevi in white patients with longitudinal melanonychia involving a single digit and to determine whether longitudinal melanonychia caused by a nail matrix nevus can be clinically distinguished from longitudinal melanonychia from other causes.

METHODS:

From January 1989 to December 1994 we performed a nail biopsy on 100 of 128 consecutive white patients who had a single band of "idiopathic" longitudinal melanonychia.

RESULTS:

A nail matrix nevus was detected in 22 patients. A junctional nevus was found in 19 specimens and a compound nevus in three specimens.

CONCLUSION:

Nail matrix nevi in Caucasian patients are uncommon but not exceptional. The number of nevi presenting with longitudinal melanonychia exceeded that of melanoma. The diagnosis of nail matrix nevi is impossible clinically and always requires histopathologic study. The pathologic features of nail matrix nevi are similar to those of skin nevi except for their architectural pattern, which reflects the peculiar anatomy of the nail unit

.

2. Cutis. 2001 May;67(5):409-11.

Evaluation of pigmented lesions of the nail unit.

Hirsch RJ, Weinberg JM.

Abstract

Acquired pigmentary changes of the nail are secondary to a number of etiologies. These include nail matrix nevi; physical induction secondary to trauma; malignant melanoma; nutritional deficiencies; inflammation secondary to lichen planus; endocrine causes such as Addison's disease; or secondary to bacterial, fungal, or viral infections. The most important task faced by clinicians is to distinguish benign from malignant etiologies of nail pigmentation. We will briefly review the various entities that can yield dyspigmentation and their differentiation from melanoma of the nail.

3. Ann Dermatol Venereol. 2004 Nov;131(11):984-6.

[Nail unit blue melanocyte nevi: 2 case reports].

[Article in French]

Moulonguet-Michau I, Abimelec P.

Abstract

INTRODUCTION:

Nail unit blue nevus is a rare and benign melanocyte proliferation of the nail unit matrix.

OBSERVATIONS:

We report two cases of nail matrix blue nevi with a blue-black spot of the lunular area associated in the first case with a longitudinal nail groove.

COMMENTS:

The analysis of our cases and of the previously reported cases give us the opportunity to describe different clinical and histological presentations.

4. J Am Acad Dermatol. 2006 Apr;54(4):664-7.

Melanotic macule of nail unit and its clinicopathologic spectrum.

Husain S, Scher RK, Silvers DN, Ackerman AB.

Abstract

The clinical and histologic spectrum of melanotic macule of the nail unit is examined and the differences in the clinical appearance of longitudinal melanochychia caused by melanotic macule and by other kinds of proliferations of melanocytes are assessed. We observed that the clinical appearance of the pigmented band was of little help in establishing the underlying basic pathologic process. This underscores the importance of obtaining a biopsy of the nail matrix in patients who present with solitary longitudinal melanonychia.

5. Dermatol Res Pract. 2012;2012:353864. doi: 10.1155/2012/353864. Epub 2012 Mar 14.

Tangential Biopsy Thickness versus Lesion Depth in Longitudinal Melanonychia: A Pilot Study.

Di Chiacchio N, Loureiro WR, Michalany NS, Kezam Gabriel FV.

Abstract

Longitudinal melanonychia can be caused by melanocyte activation (hypermelanosis) or proliferation (lentigo, nevus or melanoma). Histopathologic examination is mandatory for suspicious cases of melanomas. Tangential biopsy of the matrix is an elegant technique avoiding nail plate dystrophy, but it was unknown whether the depth of the sample obtained by this method is adequate for histopathologic diagnosis. Twenty-two patients with longitudinal melanonychia striata were submitted to tangential matrix biopsies described by Haneke. The tissue was stained with hematoxylin-eosin and the specimens were measured at 3 distinct points according to the total thickness: largest (A), intermediate (B) and narrowest (C) then divided into 4 groups according to the histopathologic diagnosis (G1: hypermelanosis; G2: lentigos; G3: nevus; G4: melanoma). The lesions were measured using the same method. The mean specimen/lesion thickness measure values for each group was: G1: 0,59/0,10 mm, G2: 0,67/0,08 mm, G3: 0,52/0,05 mm, G4: 0,58/0,10 mm. The general average thickness for all the specimens/lesions was 0,59/0,08 mm. We concluded that the tangential excision, for longitudinal melanonychia, provides an adequate material for histopathological diagnosis.

请见下载的图片，甲母质痣表现的形态。

受bre0001老师启发，本例诊断甲母质痣（ nail matrix nevi ），也叫纵行黑甲（longitudinal melanonychia)。它的评价犹如皮肤黑素细胞病变。可以恶变为恶黑。

本例不是恶黑。

请临床医生看看吧，没见过

目前不是恶性的，但以后要防止恶黑

 皮肤科对此病称为甲母质痣，基本是良性的，如果宽度大于0.6或者超过指甲一般以上，要处理掉得好

学习

word文档，图片没传上，不好意思。

（图片和你这差不多一样一样的，但着色更深。）

纵行黑甲(转图片及资料）。
可见于黑素班、甲下雀斑样痣、黑素细胞痣和黑色素瘤，也可以真菌感染，X光照射，营养不良，爱滋病或服用特殊的药品等等。总而言之要检查看看有否基础病，如果都没有也可能就是个黑素班。

2012-2-9 15:26 上传

下载附件 (596.58 KB)

看看观手知识健康讲座，有观指甲内容。

不考虑恶黑！查查霉菌，真菌？

谢谢老师，记得告诉我

 见过一次，良性病变，名字很特别，记不起来啦，明天回班上查查

第一，这么整齐， 这么棕黄，不像是黑色素瘤（恶黑）。恶黑生长是不对称性的，哪有像这样如同画笔画过或美甲的作为。

第二，要仔细回忆有没有外伤史（如夹伤）或灼伤史，伤后色素沉积。

第三，有没有接触过或误涂过含铜离子之类的重金属化合物或涂料或化学品，由金属铜离子之类的物质沉积。

第四，查血铜、血铅等血中金属离子浓度，看有没有某种金属离子代谢性疾病。没有的，就可除外。

等等。

像灰指甲，请皮肤科查查霉菌，对症治疗。