Presentation, Histopathologic Findings, and Clinical Outcomes in 7 Cases of Melanoma In Situ of the Nail Unit

High, Whitney A.; Quirey, Robert A.; Guillén, David R.; Muñoz, Gonzalo; Taylor, R. Stan

doi:10.1001/archderm.140.9.1102

Cited by 79 publications

(107 citation statements)

References 19 publications

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“…Consequently, traditional surgical intervention for this type of malignancy has focused predominantly on radical surgery, namely phalanx amputation. Nonamputative excision has been rarely advocated in the surgical literature [4,9,10,11,12]. …”

Section: Discussionmentioning

confidence: 99%

“…The use of tissue-sparing Mohs micrographic surgery for thin NUMs is an alternative that has potential benefit in avoiding amputation. However, it is not available in all centres [4]. …”

Section: Discussionmentioning

confidence: 99%

“…Moreover, melanoma of the nail region is often asymptomatic for a prolonged period. Many patients only notice a pigmentation after trauma to the area, and two thirds seek delayed medical advice because of the appearance of the lesion [4,5,6]. However, the incidence of melanoma is low in regard of the high frequency of trauma in this location.…”

Section: Introductionmentioning

confidence: 99%

“…However, histopathological diagnosis remains the gold standard in doubtful cases and is the most valuable prognostic tool [4,8]. …”

Section: Introductionmentioning

confidence: 99%

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Nail Matrix Melanoma in situ: Conservative Surgical Management

Duarte¹,

Correia²,

Barros³

et al. 2009

Dermatology

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Background: Nail unit melanoma (NUM) is a rare variant of acral lentiginous melanoma. The differential diagnosis is wide but an acquired brown streak in the nail of a fair-skinned person must be considered a potential melanoma. Dermatoscopy helps clinicians to more accurately decide if a nail apparatus biopsy is necessary. Methods: We report the case of a 61-year-old Caucasian woman with melanonychia occupying the central portion of the right thumbnail plate with 1 year of evolution. Dermatoscopy showed a brown pigmentation overlaid by longitudinal irregular lines. An excisional biopsy was performed, and pathological examination revealed melanoma in situ. For safety reasons, the nail unit was totally removed down to the phalangeal bone 3 weeks later, and a full-thickness skin graft taken from the arm was used for reconstruction. Conclusion: NUMs pose a difficult treatment challenge. Wide excision with phalanx amputation is not satisfactory for patients with in situ and early invasive melanoma. Full-thickness skin grafting after total nail unit excision is a simple procedure providing a good functional and cosmetic outcome.

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Section: Discussionmentioning

confidence: 99%

“…The use of tissue-sparing Mohs micrographic surgery for thin NUMs is an alternative that has potential benefit in avoiding amputation. However, it is not available in all centres [4]. …”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“…However, histopathological diagnosis remains the gold standard in doubtful cases and is the most valuable prognostic tool [4,8]. …”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Nail Matrix Melanoma in situ: Conservative Surgical Management

Duarte¹,

Correia²,

Barros³

et al. 2009

Dermatology

View full text Add to dashboard Cite

show abstract

“…3), which is defined as a Breslow tumor thickness (TT) ≤0.5 mm [33][34][35][36][37][38]. There have also been a few case reports of two-step surgeries using artificial dermis tissue for the tentative coverage of the defect after local excision, followed by skin graft coverage after the histopathological confirmation of negative surgical margins [39,40].…”

Section: In Situ or Minimally-invasive Summentioning

confidence: 99%