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The resulting limited experience with this condition means that dermatologists are reticent about performing biopsies because of concerns that these may cause nail dystrophy.16 Often, this leads to partial or inadequate biopsies that may be insufficient to obtain a reliable histologic diagnosis.3,68 For the same reason, pathologists encounter problems in the interpretation of nail biopsies.8,9 In addition to the low number of such biopsies, pathologists are faced with inappropriate specimens due to the way the biopsy was performed (for example, because the matrix in a melanocytic lesion was not included or because of the transverse instead of longitudinal orientation of the biopsy) as well as incorrect specimen processing.7,10 The histological preparation obtained from a nail biopsy, whose consistency requires special processing techniques, therefore often includes retraction artefacts or the preparation is incorrectly oriented.2,10,11 To make matters worse, the nail is a site with its own particularities and the density and distribution of melanocytes differ from those in the rest of the skin.79,11,12 Nevertheless, it is possible to perform suitable biopsies of melanocytic nail lesions causing only very limited permanent damage, using relatively simple techniques.1,4,6,11 On the other hand, although histological interpretation of these lesions is not easy, a suitable biopsy and appropriate specimen processing and orientation, as well as awareness of the specific characteristics of nail melanocytes, can be of help.4,7,9,13 The present article aims to analyze the clinical and histological characteristics of melanocytic lesions of the nail and offer a diagnostic algorithm for pigmented lesions of the nail apparatus

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