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Subungual amelanotic melanoma: a diagnostic pitfall
Postgraduate Medical Journal
|March 1, 1990
Summary
A persistent amelanotic nail bed lesion in a 35-year-old woman was diagnosed as malignant melanoma. Early biopsy of such lesions is crucial for timely diagnosis and treatment of nail melanoma.
Area of Science:
- Dermatology
- Oncology
- Podiatry
Background:
- Malignant melanoma can occur in unusual locations, including the nail bed.
- Amelanotic melanoma lacks pigment, making it harder to diagnose clinically.
Observation:
- A 35-year-old female presented with a year-long amelanotic lesion on her left great toenail bed.
- The lesion caused destruction of the overlying nail.
Findings:
- Incisional biopsy confirmed nodular malignant melanoma.
- The patient underwent amputation of the affected toe.
- No recurrence was observed at an 18-month follow-up.
Implications:
- Prognosis of malignant melanoma is strongly linked to local disease extent.
- Persistent nail bed lesions, even amelanotic ones, warrant biopsy to rule out melanoma.
- Early detection and intervention are critical for improving outcomes in nail bed melanoma.