From the Guidelines
Hyperpigmentation under the nails in infants is most commonly caused by melanin deposition, which is typically benign and often related to the child's genetic background. In darker-skinned infants, longitudinal melanonychia (dark streaks in the nail) is a normal variant and doesn't require treatment 1. Other causes include trauma to the nail matrix, which can trigger melanin production, or certain medications like antimalarials or chemotherapy agents. In rare cases, congenital conditions such as Laugier-Hunziker syndrome or Peutz-Jeghers syndrome may be responsible. While uncommon in infants, fungal infections can sometimes cause nail discoloration that appears as hyperpigmentation.
Some key points to consider:
- Parents should monitor any changes in the appearance of the hyperpigmentation, particularly if it spreads, changes shape, or is accompanied by pain or nail deformity.
- If the hyperpigmentation appears suddenly, affects multiple nails, or is associated with other symptoms, medical evaluation is recommended to rule out underlying conditions.
- Most cases of nail hyperpigmentation in infants are harmless and resolve on their own without requiring any intervention.
- According to the management recommendations for cardio-facio-cutaneous syndrome, dermatologic evaluation is necessary to assess for keratosis pilaris, ulerythema ophryogenes, eczema, progressive multiple pigmented nevi, dystrophic nails, lymphedema, hemangiomas, hyperkeratosis, and generalized hyperpigmentation 1.
- The provided evidence does not directly address the cause of hyperpigmentation under the nails in infants, but it highlights the importance of monitoring and evaluating any changes in the nail appearance 1.
It is essential to prioritize the child's overall health and well-being, and if any concerns arise, a medical evaluation should be sought to rule out underlying conditions.
From the Research
Hyperpigmentation under the Nails in Infants
- The provided studies do not specifically address the cause of hyperpigmentation under the nails in infants.
- However, hyperpigmentation in general can result from excess melanin, cutaneous iron deposits, cutaneous carotene deposits, or cutaneous deposits of a substance not normally found in the skin 2.
- Hyperpigmentation can be classified as localized or generalized, with localized forms generally corresponding to skin tumors or pigmented forms of inflammatory and/or infectious dermatoses, and generalized forms often being a sign of systemic disease 2.
- In children with skin of color, certain disorders of hyper- and hypopigmentation are more common, and accurate diagnosis is crucial to prevent delay in treatment and enhance quality of life 3.
- While the studies do not provide a direct answer to the question of hyperpigmentation under the nails in infants, they suggest that hyperpigmentation can have various causes, including genetic and non-genetic factors, and that accurate diagnosis and treatment are essential 4, 5, 6.