Subungual Melanoma

Abstract

Subungual melanoma (SUM) is a subtype of acral melanoma. Its incidence in dark phototypes, Hispanics and Asians, is around 20% and accounts for 50% of acral melanomas. It is an infrequent subtype in Caucasians representing only 3%. Subungual melanoma arises from dormant melanocytes in the nail matrix and exceptionally from melanocytes in the nail bed. In its initial phases of radial growth, it presents as longitudinal melanonychia. The differential diagnoses are melanocytic activation (racial, traumatic), nail matrix nevi, and lentigos. Prognosis depends on Breslow depth at diagnosis. For in situ melanoma, treatment consists of conservative surgical removal of the nail unit with 5 mm margins.

Unusual location of subungual amelanotic melanoma in 39-year-old patient: a rare case report

“…Among these, SSM represents the most prevalent subtype of cutaneous melanoma 4 , and ALM is the rarest of them 6 . Subungual melanoma, which arises from the nail apparatus, is typically a variant of ALM 7 . AM is an infrequent variant of melanoma, characterized by the lack of melanin (hypomelanotic melanoma) or the absence of it (non-pigmented) which is even more uncommon 13 .…”

“…ALM lesions are often misdiagnosed as fungal infections, warts, or diabetic foot ulcers so it is usually lately diagnosed 5 . Subungual melanoma (SUM) is typically a variant of ALM 7 . It is thought that ALM is not associated with sun exposure as other melanomas and it is more common to originate from the feet than the hands 8 .…”

“…It is thought that ALM is not associated with sun exposure as other melanomas and it is more common to originate from the feet than the hands 8 . Late and invasive SUM cases usually impose aggressive treatment, especially when 50% of subungual melanoma patients came with metastases 7 . When microscopical examination revealed amelanotic or hypomelanotic melanoma that called amelanotic melanoma (AM) which happens in bout 4–27.5% of all melanoma cases 9 .…”