[Malignant melanoma of the nailbed under a skin graft]

The authors report on a case of subungual malignant melanoma, which developed beneath a split-skin graft. The patient had an accident which caused a pathologic growth of the nail. Eleven years later the patient removed the nail, because it became moist, and a surgeon grafted the nail-bed with a split-thickness skin. Six years later we saw a 2 X 2 cm tumor under the skin graft and histologic examination showed a nodular malignant melanoma. Diagnostic and therapeutic guidelines for subungual and acral melanomas are discussed.