Subungual Melanoma of the Hand

Chakera, Annette Hougaard; Quinn, Michael J.; Lo, Serigne; Drummond, Martin; Haydu, Lauren E.; Bond, Jeremy S; Stretch, Jonathan R.; Saw, Robyn P.M.; Lee, Ken J; McCarthy, William H.; Scolyer, Richard A.; Thompson, John F.

doi:10.1245/s10434-018-07094-w

Cited by 31 publications

(51 citation statements)

References 31 publications

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“…Due to the advanced tumor thickness, there is a high risk of lymph node metastases. In a study with 94 SUM patients, 44% had either positive sentinel lymph nodes or macroscopic lymph node metastases (Chakera et al, 2019). We This surgical treatment is associated with a very low rate of local recurrence (<7%) and offers better functional and cosmetic outcomes than amputation (Flores-Terry et al, 2018).…”

Section: Discussionmentioning

confidence: 85%

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Subungual melanoma: A single center series from Dresden

Wollina

Tempel

Hansel

2019

Dermatologic Therapy

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Subungual melanoma (SUM) is a rare subtype in Caucasians. Histologically, most tumors are of the acrolentiginous type (ALM). This is a retrospective analysis of the years 2002–2019 at a certified skin cancer center. We observed 12 SUM patients with a median age of 76 years, seven men and five women (0.6% of all melanomas). The delay of diagnosis reached from 30 years to several months. Hallux and thumb were the most affected localizations. The dominant histologic type was ALM. Clinical symptoms were nail plate destruction (90.9%), bleeding (50.0%), pigmentation of the nail plate (33.3%), and a positive Hutchinson sign (25.0%). All tumors were treated surgically with three‐dimensional margin control. In six patients, amputation was performed. Median relapse‐free survival and overall survival were (56 ± 73.5) months and (112.5 ± 135.1) months, respectively. SUM is rare among Caucasian patients. Nail plate pigmentation and Hutchinson sign were not frequent. Amelanotic ALM with nail plate destruction was the dominant presentation in our series. Dermoscopy is of limited value for amelanotic subungual tumors. Early biopsy of unusual or treatment resistant nail disorders is recommended.

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Section: Discussionmentioning

confidence: 85%

“…Due to the advanced tumor thickness, there is a high risk of lymph node metastases. In a study with 94 SUM patients, 44% had either positive sentinel lymph nodes or macroscopic lymph node metastases (Chakera et al, ). Another Australian study reported a median survival for SUM of 4.6 years (Reilly et al, ).…”

Section: Discussionmentioning

confidence: 99%

Subungual melanoma: A single center series from Dresden

Wollina

Tempel

Hansel

2019

Dermatologic Therapy

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“…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) .…”

Section: Resultsmentioning

confidence: 99%

“…Mean Breslow values were available from 12 studies with unselected tumour thicknesses and ranged from 0.82 to 8.70 mm . Ulceration status was mentioned with rates between 8.3% and 70.8% in 13 studies . Sentinel lymph node biopsy (SLNB) was performed in 12 studies, and positivity rates varied between 0% and 30.6% .…”

Section: Resultsmentioning

confidence: 99%

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

Lieberherr

Cazzaniga

Haneke

et al. 2020

Acad Dermatol Venereol

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Nail apparatus melanoma (NAM) is a rare dermatologic malignancy. Its prognosis is poor because it is often diagnosed late. However, progression and survival of NAM patients have only been studied among small populations. Early biopsy could help to identify suspicious lesions at a less invasive stage. While surgery is generally seen as the treatment of choice, the extent of excision margins and the use of sentinel biopsy remain debated. This systematic review aims to summarize the treatment procedures and observed prognosis in the literature during the last two decades and present pooled survival and progression rates of NAM by using meta-analysis. A systematic review on studies assessing pathology, treatment and prognosis of NAM was carried out up to end of 2018. After evaluation of eligible studies, the main emerging topics were outlined and pooled survival outcomes estimated. A total of 30 articles out of 624 identified records were included for systematic review. Finally, meta-analysis of pooled mortality rates including 18 studies was 4.6 9 100 patient-years (95% CI: 2.7, 6.8) equivalent to 5-year cumulative survival of 77.0%. Additionally, the pooled progression rate based on 17 studies was 6.3 9 100 patient-years (95% CI: 4.1, 8.9) with estimated 5-year cumulative progression-free survival of 68.5%. While the optimal extent of surgical treatment remains debated, prompt biopsy could help to identify early lesions. This is the first study to present pooled survival and progression rates by meta-analysis.

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Surgical excision methods for skin cancer involving the nail unit: A systematic review

Hardie,

Wade,

Wormald

et al. 2023

Cochrane Evidence Synthesis and Methods

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IntroductionSkin cancer affecting the nail unit is rare but is associated with morbidity, and melanoma has a high mortality rate. The principal treatment is surgical excision and methods can be classified into digit‐sparing surgery or amputation. Digit‐sparing surgery (wide excision or Mohs surgery) may be safe and effective for malignancies involving the nail unit in comparison to amputation if there is not bony invasion. The objective was to assess the efficacy and safety of different methods of surgical excision for skin cancer involving the nail unit.MethodsProspective comparative studies (randomized controlled studies, non‐randomized controlled studies and prospective observational studies) of surgical excision for skin cancer of the nail unit in all participants were eligible for inclusion. We searched electronic databases, trials registers and conference abstracts. We checked the reference lists of included studies and related systematic reviews for further references to relevant studies, and we contacted experts to enquire if they were aware of any additional relevant trials. We used standard methodological procedures expected by Cochrane. The primary outcomes were overall survival, disease free survival and adverse events/outcomes at 30 days. The secondary outcomes were quality of life outcomes. We planned to use GRADE to assess the quality of the evidence for each outcome.ResultsWe did not identify any studies that met the inclusion criteria for this review. We have been unable to assess our outcomes of overall survival, disease free survival, adverse events/effects and quality of life.ConclusionsAs we have not identified any studies for inclusion, we are unable to assess the efficacy and safety of different methods of surgical excision for skin cancer involving the nail unit. We suggest that comprehensive cancer registry analysis is required in this field to obtain meaningful data.

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Subungual Melanoma of the Hand

Cited by 31 publications

References 31 publications

Subungual melanoma: A single center series from Dresden

Subungual melanoma: A single center series from Dresden

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

Surgical excision methods for skin cancer involving the nail unit: A systematic review

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