Abstract
To the Editor.— Although this is an important finding, most pigmented nail bands seen in clinical practice are due to less esoteric causes. A host of factors can be related to local or diffuse discoloration of the nail bed or nail plate, and many of these have characteristic physical findings. Subcutaneous hemorrhage, the most common cause of darkening of part of a nail, is usually accompanied by a history of pain or trauma. Pigmentation of the nail caused by chromogenic fungae is accompanied by onycholysis. Multiple bands can be seen in patients with Peutz-Jeghers syndrome1,2and some drugs, such as antimalarials, can produce longitudinal pigmentation in the nail bed. Increase in melanin in the nail bed is also seen with vitamin B12deficiency3and pinta.4 Narrow pigmented bands which extend from the proximal nail fold to the distal free edge in an otherwise normal nail suggest
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