Ren J, Ren M, Kong YY, et al. - Researchers conducted an analysis of 35 cases distinguished by excision specimens to evaluate the clinicopathologic diversity and outcome of longitudinal melanonychia in children and adolescents. Thirty-five pediatric cases identified by excision specimens on their clinicopathologic features were retrospectively reviewed, and fluorescence in situ hybridization test on available 13 cases was conducted. Fingernails were more likely to be affected in 77.1%. They found total melanonychia and Hutchinson’s sign in 10 (28.6%) and 14 (40.0%) cases, respectively. The data reveal that in adults, some concerning clinicopathologic characteristics, which are signs indicative of melanoma, are not uncommon in pediatric longitudinal melanonychia, particularly in patients ≤ 10 years. The results recognize that in pediatric longitudinal melanonychia, owing to the extremely low incidence of melanoma, a more conservative strategy should be adopted under most circumstances.