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Longitudinal Erythronychia

Retrospective Single-Center Study Evaluating Differential Diagnosis and the Likelihood of Malignancy

Jellinek, Nathaniel J. MD; Lipner, Shari R. MD, PhD

doi: 10.1097/DSS.0000000000000594
Original Article

BACKGROUND Longitudinal erythronychia (LE) is an underappreciated and understudied clinical diagnosis. The rates of malignancy and prevalence within the differential diagnosis are not well-established.

OBJECTIVE To examine the prevalence of biopsy-proven diagnoses in patients presenting with LE.

METHODS Retrospective single-center study of 65 consecutive patients undergoing biopsy of LE.

RESULTS Malignancy was identified in only 3 of 65 cases (in situ carcinoma in 2 and melanoma in 1). Onychopapilloma was the most common diagnosis in cases of localized LE. Lichen planus was the most common diagnosis in cases of polydactylous (generalized) LE.

CONCLUSION Longitudinal erythronychia is not a rare clinical finding. The differential diagnosis includes neoplasms, inflammatory conditions, infectious conditions, and scar. Clinicopathologic correlation is required to make the diagnosis in many cases. Malignancy is uncommon, but not rare, with squamous cell carcinoma in situ representing the most common malignancy.

*Dermatology Professionals, Inc., East Greenwich, Rhode Island;

Division of Dermatology, University of Massachusetts Medical School, Worcester, Massachusetts;

Department of Dermatology, The Warren Alpert Medical School at Brown University, Providence, Rhode Island;

§Department of Dermatology, Weill Cornell Medical College, New York, New York

Address correspondence and reprint requests to: Nathaniel J. Jellinek, MD, 1672 South County Trail, Suite 101, East Greenwich, RI 02818, or e-mail:

Supported by an unrestricted mentorship grant from the Council for Nail Disorders. The authors have indicated no significant interest with commercial supporters.

© 2016 by the American Society for Dermatologic Surgery, Inc. Published by Wolters Kluwer Health, Inc. All rights reserved.
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