Clinical features of subungual melanoma according to the extent of Hutchinson’s nail sign: a retrospective single‐centre study

Sohng, Chihyeon; Han, Man‐Hoon; Park, D.; Park, K.D.; Jang, Yo-Soon; Lee, W.J.; Lee, S.J.; Kim, J.Y.

doi:10.1111/jdv.16762

Cited by 8 publications

(5 citation statements)

References 18 publications

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“…Sohng et al. demonstrated that the Hutchinson sign affecting over two nail folds was positively correlated with amputation or higher T stage 44 . Hyokyung et al.…”

Section: Discussionmentioning

confidence: 99%

Slow Mohs micrographic surgery for nail apparatus melanoma in situ

et al. 2023

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BackgroundNail apparatus melanoma is a malignant tumor with a high incidence in Chinese melanoma patients. Slow Mohs micrographic surgery is an emerging technique for treating nail apparatus melanoma in situ (NAMIS).ObjectiveThis study evaluated the efficacy and safety of slow Mohs micrographic surgery for treating NAMIS.MethodsPatients were enrolled in this retrospective study and treated in a single center from October 1, 2016, to June 30, 2022. Each patient underwent standard slow Mohs micrographic surgery, and follow‐up was regularly conducted at clinics.ResultsTen patients were enrolled in the study. Two patients underwent one Mohs stage, seven underwent two Mohs stages, and one underwent seven Mohs stages. The resection margin ranged from 5 to 25 mm. No severe complications were reported in the treatment, and recurrence of NAMIS was not observed during the follow‐up period.ConclusionSlow Mohs micrographic surgery is a valuable surgical method to treat NAMIS that preserves digit function and can be well tolerated by patients.

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“…Sohng et al. demonstrated that the Hutchinson sign affecting over two nail folds was positively correlated with amputation or higher T stage 44 . Hyokyung et al.…”

Section: Discussionmentioning

confidence: 99%

Slow Mohs micrographic surgery for nail apparatus melanoma in situ

et al. 2023

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“…2,13 Also, a recent study has shown that the extent of HS is significantly associated with higher tumor stage of SUM. 14 Therefore, in invasive melanoma, HS is much more likely to be observed and the melanoma cells are more likely to be visible in a pathologic examination of HS, which in turn may result in a bias. Thus, we attempted to confirm our assumptions in the early stage of SUM.…”

Section: Discussionmentioning

confidence: 99%

Hutchinson Sign: Biopsy May Assist in Diagnosis of Subungual Melanoma in Situ

Oh¹,

Lee²,

Park³

et al. 2021

Dermatol Surg

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BACKGROUND Early and accurate diagnosis of subungual melanoma (SUM) through histopathologic examination is critical, but lack of clinical suspicion leads to delays in diagnosis. Hutchinson sign (HS) can be one of the important clinical indicators for diagnosing SUM. OBJECTIVE To evaluate the diagnostic value of small biopsies of HS for detecting SUM in situ. METHODS We retrospectively evaluated 12 patients who were diagnosed as SUM in situ and underwent punch biopsy at HS areas. Clinical features, dermoscopic findings, and histopathologic findings in HS regions were analyzed. RESULTS In most cases, HS was seen in hyponychium (11/12, 91.7%) with 1 case found in proximal nail fold, and 1 case in both the hyponychium and proximal nail fold. Dermoscopic features of HS showed irregular diffuse pigmentation (12/12, 100%) and parallel ridge pattern (7/12, 58.3%). Histopathologically, all cases showed irregularly scattered atypical melanocytes with hyperchromatic nuclei. Two cases showed subtle changes in melanocytes with little nuclear atypia, but additional section specimen showed more definitive findings of SUM in situ. CONCLUSION We present a supplementary biopsy technique for diagnosing SUM. Biopsy of HS may help in the diagnosis of SUM.

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“…The latter has been described as a periungual extension of pigment that may affect the nail folds and/or the hyponychium. This finding has been associated with an increased risk for advanced‐stage melanoma 5 …”

Section: Clinical Challengesmentioning

confidence: 97%

Clinicohistopathologic challenges and traps in the diagnosis of nail unit melanoma

Jiang¹,

Abbott

Higgins

et al. 2023

J Cutan Pathol

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Melanoma of the nail apparatus is challenging to diagnose for both dermatologists and dermatopathologists. Misdiagnosis or delayed diagnosis of nail unit melanoma can have fatal consequences and legal ramifications. This review educates dermatopathologists on challenges and traps they should be aware of to avoid misdiagnosis of nail unit melanoma. We present illustrative difficult cases that introduce several themes regarding challenges in the diagnosis of nail unit melanoma: specimens with subtle histopathologic findings, challenges in immunoperoxidase interpretation, and how clinical knowledge and surgical procedural knowledge are mandatory to make the diagnosis. Dermatopathologists will be aware of when and how to suspect nail unit melanoma in unusual circumstances.

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Clinical features of subungual melanoma according to the extent of Hutchinson’s nail sign: a retrospective single‐centre study

Cited by 8 publications

References 18 publications

Slow Mohs micrographic surgery for nail apparatus melanoma in situ

Slow Mohs micrographic surgery for nail apparatus melanoma in situ

Hutchinson Sign: Biopsy May Assist in Diagnosis of Subungual Melanoma in Situ

Clinicohistopathologic challenges and traps in the diagnosis of nail unit melanoma

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