In situ nail unit melanoma: epidemiological and clinic‐pathologic features with conservative treatment and long‐term follow‐up

Abstract

The recognition of a NUM at an in situ stage allows early treatment and curing of this tumour. At this early stage, a 'functional surgery' is a rational approach with an excellent oncologic safety.

Melanoma of the nail apparatus: a systematic review and meta‐analysis of current challenges and prognosis

“…The number of patients per study varied between 2 and 157. Nine studies were restricted to NAM in situ or minimally invasive (<0.5 mm) melanoma …”

“…Details about gender distribution were available in 28 studies and showed a male/female ratio between 0.3–2.5 : 1 . Information on population age was given in 28 studies with a reported average age between 41.1 and 67 years (age range: 5–94 years) . A total of 818 of the NAM were located on the hand and 522 lesions on the foot.…”

“…Applied lateral and proximal safety excision margins from the nail plate or clinically apparent lesion were inconsistent and ranged from 5 to 10 mm for both in situ and invasive melanomas or were indistinct with 3–5 mm or ‘wide’ or ‘generous’ . Deep margin resection included or excluded the periosteum.…”

“…Besides healing by secondary intention, different defect reconstruction techniques were chosen. In the most frequent approach, a full‐thickness skin graft (FTSG) was harvested from forearm, lower abdomen, groin, inner arm or thigh .…”

“…In 700 cases (52.5%), amputation was the treatment of choice and consisted in the partial or full resection of one or more phalanges and/or metacarpal or metatarsal bones. Reported levels of amputation were (ranging from distal to proximal) the partial amputation of the distal phalanx, distal interphalangeal joint, median phalanx, proximal interphalangeal joint, metacarpo‐/metatarsophalangeal joint, metacarpal/metatarsal and carpometacarpal joint …”