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pigmentation is nonmelanocytic) Drug reactions (hydroxyurea, antiretrovirals, antimalarials, metals) Endocrine disease (Addison disease, Cushing syndrome) Nonmelanocytic tumours (squamous cell carcinoma in situ, onychomatricoma, myxoid cyst, viral warts) Melanocytic naevus of nail matrix Lentigo / benign melanocytic hyperplasia Malignant melanoma Nails grow slowly, taking months to reach the distal edge, and longitudinal melanonychia reflects melanin deposition rather than the site of its production