1/36. Subungual malignant melanoma mimicking a squamous cell carcinoma.When a suspicious lower-extremity lesions is encountered, an appropriate biopsy should be performed. The lesion must then be excised with the proper margins and submitted for pathologic evaluation to ensure complete removal.- - - - - - - - - - ranking = 1keywords = melanoma, malignant melanoma (Clic here for more details about this article) |
2/36. The ABC rule for clinical detection of subungual melanoma.BACKGROUND: Subungual melanoma is a relatively rare disease with reported incidence between 0.7% to 3.5% of all melanoma cases in the general population. Unlike the significant improvement in the diagnosis of cutaneous melanoma, the diagnosis of subungual melanoma has shown little, if any, improvement over the years. The widespread adoption of the ABCDs of cutaneous melanoma has helped increase public and physician awareness, and thus helped increase the early detection of cutaneous melanoma; the same criteria cannot be applied to the examination of the nail pigmentation. OBJECTIVE: We reviewed the world literature on subungual melanoma and arranged the available information into a system for the identification of subungual melanoma. This system has to be thorough, easy to remember, and easy to apply by both physician and lay public. A case to illustrate the delayed diagnosis often encountered in the current evaluation of nail melanoma is presented. methods: A thorough review of the world literature on subungual melanoma was undertaken. The important findings of various studies and case reports were compared among themselves and the salient features were summarized. The information was then categorized under the easily recalled letters of the alphabet, ABCD, that have already become associated with melanoma. RESULTS: The most salient features of subungual melanoma can be summarized according to the newly devised criteria that may be categorized under the first letters of the alphabet, namely ABCDEF of subungual melanoma. In this system A stands for a ge (peak incidence being in the 5th to 7th decades of life and african americans, Asians, and native Americans in whom subungual melanoma accounts for up to one third of all melanoma cases. B stands for brown to black b and with breadth of 3 mm or more and variegated borders. C stands for change in the nail band or lack of change in the nail morphology despite, presumably, adequate treatment. D stands for the digit most commonly involved; E stands for extension of the pigment onto the proximal and/or lateral nailfold (ie, Hutchinson's sign); and F stands for family or personal history of dysplastic nevus or melanoma. CONCLUSION: Although each letter of the alphabet of subungual melanoma is important, one must use all the letters together to improve early detection and thus survival of subungual melanoma. Still, as with cutaneous melanoma, the absolute diagnosis of subungual melanoma is made by means of a biopsy.- - - - - - - - - - ranking = 4.4904894498234keywords = melanoma (Clic here for more details about this article) |
3/36. Subungual amelanotic melanoma.We describe a 76-year-old white male with subungual amelanotic melanoma. The lack of pigmentation of the lesion may cause misdiagnosis and aggravate its poor prognosis.- - - - - - - - - - ranking = 0.93551863537987keywords = melanoma (Clic here for more details about this article) |
4/36. Early malignant melanoma manifested as longitudinal melanonychia: subungual melanoma may arise from suprabasal melanocytes.A 51-year-old woman developed longitudinal melanonychia of 3 months' duration on the right index fingernail. A biopsy specimen revealed that atypical melanocytes were distributed in the lower third of the matrix epithelium but were few in number at the basal layer. The involved nail matrix was resected because of continual growth of the lesion after the biopsy. It has been proven in normal nail matrices that melanocytes are distributed not only in the basal layer but also in the lower half of the epithelium. It is therefore understandable that malignant melanoma of the nail matrix can arise from melanocytes situated in the squamous epithelium above the basal layer. The present case is a good example in which malignant melanoma of the nail matrix may arise from the intraepithelial region where melanocytes normally reside.- - - - - - - - - - ranking = 2.2484149083039keywords = melanoma, malignant melanoma (Clic here for more details about this article) |
5/36. Childhood longitudinal melanonychia: case reports and review of the literature."Longitudinal melanonychia" refers to a brown or brown-black longitudinal band on a fingernail or toenail. A number of conditions can cause longitudinal melanonychia, but its main importance is that, in some patients, it may indicate the presence of a subungual malignant melanoma. Hyperpigmented nail bands are not uncommon in African-American, Latino and Asian patients, especially those over sixty years of age, and are often multiple in these groups. Longitudinal melanonychia is most worrisome when there is a solitary, dark, broad longitudinal band with pigment extending over the proximal nail fold (Hutchinson's sign). Such findings are considered to be a strong indication for biopsy of the nail matrix to rule out melanoma. Since nail matrix biopsy sometimes results in permanent nail deformity, and since the incidence of malignant melanoma is quite small in the pediatric age group, there is some controversy as to whether this procedure should routinely be performed in children. We report two cases of dramatic longitudinal melanonychia in toddlers and review the current literature on the management of this striking condition in the pediatric age group.- - - - - - - - - - ranking = 0.68710372707597keywords = melanoma, malignant melanoma (Clic here for more details about this article) |
6/36. Subungual melanoma in situ: two independent streaks in one nail bed.We report an unusual case of two nail-bed streaks under one nail, revealing melanoma in situ affecting the nail bed and plate, but not the nail fold. This unusual mode of presentation together with the absence of any nail-fold involvement has not been reported previously. We highlight the need for early histological assessment of nail-bed lesions and discuss subungual melanoma.- - - - - - - - - - ranking = 1.1226223624558keywords = melanoma (Clic here for more details about this article) |
7/36. Pitfall in pigmentation: pseudopods in the nail plate.BACKGROUND: We present here a patient with an unusual type of nail plate pigmentation featuring pseudopod formation. OBJECTIVE: To identify additional dermoscopic criteria. methods: dermoscopy of the nail with control biopsy. RESULTS: Pseudopods of the nail resulted from erythrocytes entrapped between the layers of the nail plate. CONCLUSION: Pseudopod formation of the nail may represent a diagnostic criterion to distinguish hemorrhage and melanoma of the nail apparatus.- - - - - - - - - - ranking = 0.18710372707597keywords = melanoma (Clic here for more details about this article) |
8/36. Childhood subungual melanoma in situ in diffuse nail melanosis beginning as expanding longitudinal melanonychia.We report a rare childhood occurrence of melanoma in situ presenting as diffuse nail pigmentation resulting from expanding longitudinal melanonychia, and discuss factors that should come into play when considering a possible nail matrix biopsy.- - - - - - - - - - ranking = 0.93551863537987keywords = melanoma (Clic here for more details about this article) |
9/36. A surgical approach to melanonychia striata.Longitudinal pigmented streaks--melanonychia striata longitudinalis--are discussed from the perspective of a difficult diagnostic problem. These must be differentiated as early as possible from melanoma. The history of this subject and evaluation of patients in the context of various populations are reviewed. Difficult decisions and technical aspects of the approach are outlined. Case presentations contrast multiple different subungual pigmented lesions that enter into the differential diagnosis of these tumors. A larger number of lesions that make up this differential diagnosis are also discussed in addition to the cases. Appropriate biopsy is reviewed. The potential deformities from the biopsy are contrasted with dangers that are associated with some subungual pigmented tumors.- - - - - - - - - - ranking = 0.18710372707597keywords = melanoma (Clic here for more details about this article) |
10/36. Regressed subungual melanoma simulating cellular blue nevus: managed with sentinel lymph node biopsy.BACKGROUND: Subungual melanoma, a not uncommon presentation of cutaneous melanoma in Asian populations, is easily overlooked as benign and thus is improperly treated. OBJECTIVE: To present two cases with clinical suspicion of subungual melanoma. skin biopsies failed to demonstrate the diagnostic features of malignancy. methods: lymphoscintigraphy and sentinel lymph node (SLN) biopsies were performed to determine regional lymph node status. RESULTS: Both hematoxylin-eosin and HMB45 staining revealed melanoma cells in the SLN of the patient. The second patient's SLN was negative for malignant cells, but her excised primary lesion showed extensive regressed melanoma. CONCLUSION: Regression phenomena are not uncommon for subungual melanoma. An extention biopsy techniques are useful for determining nodal basin status in regressed subungual melanoma.- - - - - - - - - - ranking = 2.0581409978357keywords = melanoma (Clic here for more details about this article) |
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