Melanonychia in children is less common than in adults and it is burdened by less well-defined criteria concerning diagnosis and management. Longitudinal melanonychia is the commonest morphological pattern. Nail melanoma in children is rare, and is exceptional in Caucasians. Subungual melanoma is a type of longitudinal melanonychia, but what are the tipoffs that longitudinal melanonychia is malignant vs. benign? Differentiating benign nail pigmentations such as melanonychia from either nail or nail matrix melanoma is especially difficult in children because pediatric lesions present differently than they do in adults, according to Antonella Tosti, M.D., professor of the department of dermatology and cutaneous surgery, University of Miami Miller School of Medicine. Nail melanoma in children is rare, and is exceptional in Caucasians. Melanonychia due to melanocytic activation — Melanonychia due to melanocytic activation, also called "functional melanonychia," is the most common type of melanonychia seen in both adults and children. Melanonychia in children requires only follow-up over time. The most common cause of melanonychia in adults is melanocytic activation, with no proliferation, Dr. Jellinek said. Melanonychia is a harmless brown or black discoloration of a finger or toe nail. Melanonychia is a common cause of nail discoloration accounting for nearly half of the cases of chromonychia. Melanonychia is a medical condition in which the nail plate has a pigmentation band that is either black or brown in color. For three children, a wait-and-see policy was adopted, because their longitudinal melanonychia had been … The most common cause in children is benign proliferation - a lentigo or nevus - while malignant proliferation (melanoma) is seen much more often in adults. Melanonychia in children is usually due a nail matrix nevus. A brown or black band, stripe, streak or line in a nail is a very common occurrence in men and women of all ages and races. The data on prevalence of melanonychia comes from the studies on melanonychia striata and varies with the region and population of study. Asian or South American children with a dark phototype were mainly affected - 8 cases -, more rarely - 3 cases - Caucasian children with a fair-skinned phototype were involved and all of them were Italian. Melanonychia in children is usually due a nail matrix nevus. There are in the literature 11 cases of primary melanoma of the nail matrix presenting as longitudinal melanonychia (LM) in children. Criteria suggesting biopsy are rapid growth and black color. Clinical and dermoscopic parameters used in adults are not valid in children. In July 1999 Goettmann-Bonvallot, Andre, and Belaïch1 proposed that all cases of longitudinal melanonychia in children are probably benign and do not require diagnostic biopsy. Almost all cases of longitudinal melanonychia (LM) seen in children are benign, with the majority being due to melanocytic naevi affecting the nail matrix or nail bed. Melanonychia can present in individuals of all ages, including children, and affects both sexes equally. There are two main types of melanonychia, meaning longitudinal (this being often times a sign of subungual melanoma ) and transverse. It presents with regular, homogeneous, thin … According to the literature, almost all cases of LM seen in children are benign and nail melanoma is rare. Melanonychia most often occurs because of increased production of melanin by … Surgical excision was performed in five cases. Eight children with longitudinal melanonychya who were between the ages of 2 and 14 years underwent follow-up. 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