[Subungual malignant melanoma--30 year review of cases]

Twenty-five patients with subungual malignant melanoma confirmed by pathology from 1958 to 1987 were reported. There were 19 males and 6 females. 76% of the lesions occurred on the finger and 24% on the foot. The most common site was the thumb or great toe. 16/25 of the patients had history of subungual pigmented streaks. As trauma at the lesion site might initiate subungual melanoma (28%), doctors should pay close attention to the subungual black pigmented streaks or a mass below the nail with a history of trauma in order to avoid mis-diagnosis. In these 25 patients, the diagnosis was delayed in 19, and 10 of them already had regional lymph node metastasis. Surgical treatment still played a major role for subungual melanoma. According to the clinical staging, various degrees of amputation at different levels and regional lymph node dissection were recommended. The 5-year survival rate in this group was 28% (7/25).