Version May 2024
| Melanocytic activation |
| Physiologic causes |
| Ethnic melanonychia |
| Pregnancy |
| Local and regional causes |
| Repeated, local trauma from poor footwear or overriding toes |
| Onychotillomania |
| Nail biting |
| Occupational trauma |
| Carpal tunnel syndrome |
| Dermatologic causes |
| Psoriasis |
| Lichen planus |
| Amyloidosis |
| Chronic radiation dermatitis |
| Systemic lupus erythematosus |
| Localized scleroderma |
| Chronic paronychia |
| Onychomycosis |
| Onychomatricoma |
| Bowen disease |
| Myxoid pseudocyst |
| Basal cell carcinoma |
| Subungual fibrous histiocytoma |
| Verruca vulgaris |
| Systemic causes |
| Endocrine disorders (Addison disease, Cushing syndrome, Nelson syndrome, hyperthyroidism, acromegaly) |
| Alcaptonuria |
| Nutritional disorders |
| Hemosiderosis |
| Hyperbilirubinemia |
| Porphyria |
| Graft-versus-host disease (lichen planus-type changes accompanied by longitudinal melanonychia) |
| AIDS |
| Iatrogenic causes |
| Phototherapy |
| X-ray exposure |
| Electron beam therapy |
| Drug intake |
| Syndromes |
| Laugier-Hunziker syndrome |
| Peutz-Jeghers syndrome |
| Touraine syndrome |
| Melanocytic hyperplasia |
| Lentigo |
| Nevus |
| Congenital nevi |
| Acquired nevi |
| Nail apparatus in-situ and invasive melanoma |
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