The Prognosis of Nail Apparatus Melanoma: 20 Years of Experience from a Single Institute

Abstract

Introduction and Objectives: Nail apparatus melanoma (NAM) is an uncommon tumor, especially in Caucasians. The prognosis of patients affected by NAM was analyzed and correlated with the histopathological criteria and the surgical management of the tumors. Materials and Methods: We collected data regarding NAM referred to the Skin Cancer Unit of the Dermatology Department of the University of Bologna, from 1992 to January 2012. Results: Out of 1,327 melanoma cases diagnosed between 1992 and 2012, 42 patients were affected by NAM (2.93%). All the patients were Caucasian. Two deceased patients with insufficient medical records and 1 woman with a personal history of breast cancer were excluded. Thirty-nine cases entered this study: 24 were women (67%) and 15 men (33%). The mean age at diagnosis of NAM was 57.3 years (range 29-88 years). Statistical analyses showed that prognosis was significantly correlated with the Breslow thickness (≥/<2 mm; p = 0.02), regression (p < 0.0001) and ulceration (p = 0.04). Regarding surgical management, Kaplan-Meier's test pointed out that performing functional surgery compared to disarticulation did not correlate with a better prognosis of patients (p = 0.08). Conclusions: In our experience, the surgical management (disarticulation with respect to functional surgical excision) did not influence the prognosis of NAM patients. The latter was affected by the histopathological characteristics (Breslow thickness, regression and mitoses) and location (fingers vs. foot).

Clinical and dermoscopic clues to differentiate pigmented nail bands: an International Dermoscopy Society study

“…Patients’ data were recorded, including age, sex, location (involved finger), width of the pigmented band (categorized as less than 1/3 of the nail plate, between 1/3 and 2/3 of the nail and more than 2/3), presence or absence of nail dystrophy and Breslow thickness (for nail apparatus melanoma). The evaluated dermoscopic variables are analytically described (see Table ) and are based on literature data . Finally, the presence of granular pigmentation defined as fine light to dark brown granularity, was included in the analysis.…”

“…The evaluated dermoscopic variables are analytically described (see Table 1) and are based on literature data. 3,6,9,10 Finally, the presence of granular pigmentation defined as fine light to dark brown granularity, was included in the analysis.…”

“…3,[6][7][8] The stage of the diagnosis is the most important concept to cure the patient. 9,10 In this study, we performed clinical and dermoscopic examination of consecutive adult patients with an acquired band of longitudinal melanonychia to identify the best predictors of melanoma using a multivariate analysis and to explore possible new dermoscopic criteria for nail melanoma diagnosis.…”

Descriptive survival study of nail melanoma patients treated with functional surgery versus distal amputation

“…Our study confirms other reports in the literature that concluded that the surgical approach does not affect the prognosis of nail melanoma. [3][4][5] Although the literature shows that histologic characteristics such as tumor thickness, 4,5 presence of mitosis, and To the Editor: With recent increases in incidence rates of melanoma and nonmelanoma skin cancer (NMSC), especially in young people, skin cancer is important in survivorship research. Risk of multiple skin cancers may be associated with ultraviolet (UV) radiationerelated behaviors after a sentinel skin cancer.…”

Mohs micrographic surgery for nail unit tumours: an update and a critical review of the literature

“…45 In our experience, the conservative approach with functional surgery 46 involving the excision of the whole NU is a good option for the treatment of non-invasive NUM (MIS, Ia staging). 47,48…”