Subungual melanoma: A 25‐year review of cases

Abstract

The purpose of this study was to evaluate subungual melanoma as a site-specific entity, to determine the influence of regional nodal involvement, and to ascertain where possible the role of histologic grading of the primary site. Thirty-three patients with subungual melanoma whose median age was 56 yr underwent treatment between 1950 and 1975. There were 11 male and 22 female patients. Forty-eight per cent of lesions were 11 male and 22 female patients. Forty-eight per cent of lesions occurred on the hand. Of 23 clinical stage I patients, seven patients underwent amputation only, while 16 patients underwent amputation and regional nodal dissection. Histologic examination of the primary tumor suggested a trend towards thicker/ulcerated lesions to be associated with metastatic melanoma in regional lymph nodes and/or death due to disease. Early survival patterns favored female patients but there was no significant difference in 10-year survival when analysed by patient sex. Clinical/pathologic stages were the most significant factors affecting long-term survival with 5- and 10-year survivals of 66% and 55% in stage I patients and 22% and 0% in stage II patients.

Dermoscopic Examination of Nail Pigmentation

“…2002;138:1327-1333 E ARLY DIAGNOSIS of nail apparatus melanoma in its pigmented form is difficult because several benign conditions share the same clinical features (ie, longitudinal melanonychia). [1][2][3][4][5][6][7][8][9][10][11][12][13][14] Several clinical criteria have been proposed to help clinicians more accurately distinguish suggestive cases, 15 but neither a single clinical criterion nor a combination of symptoms currently can be used to avoid numerous useless painful nail matrix biopsies that may leave dystrophic scars. [16][17][18][19] Longitudinal melanonychia is suggestive when it is unique, polychrome, increasing in width, or accompanied by the Hutchinson sign (pigmentation of the cuticle).…”

“…Their coloration varied from purple-blue in recent lesions to brown in older lesions, and the distal edge was in some cases distorted with a somewhat linear pattern, especially in older lesions (Figure 2). (2) Brown coloration of the background in the area of the clinically observed dark band varied from light to dark with sharply delimited lateral borders. The proximal border corresponded in most cases to the proximal nail plate immediately adjacent to the cuticle; the distal border corresponded to the distal edge of the nail plate (Figures 3, 4, 5, and 6).…”

Is the Distance Enough to Eradicate in situ or Early Invasive Subungual Melanoma by Wide Local Excision? From the Point of View of Matrix-to-Bone Distance for Safe Inferior Surgical Margin in Koreans

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(SUM) in 1886, a radical surgical strategy has been recommended as a dogma for the treatment of SUM [2,3] . However, recently SUM has often been managed by conservative surgery such as wide local excision (WLE) and grafting, with which good results were achieved [4][5][6] .

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Primary Malignant Tumors of the Nail Unit

“…Some authors even favored radical surgeries such as hip exarticulations after locoregional recurrences of the lower extremity. 114 A recent study evaluated the survival rates between 2 groups of patients, those with an amputation in or proximal to the distal interphalangeal joint and those with less radical "functional" surgery. 115 A retrospective comparative analysis of these 2 treatment groups of 31 patients showed no survival difference between them at a median follow-up of 54 months.…”