Subungual malignant melanoma

A sixty year old white woman with a history of Peutz-Jeghers syndrome with nail involvement, presented with a marked hyperpigmentation of the terminal phalanx and nail of the right index finger. Two preceding biopsy specimens from the fingertip were interpreted as junction nevus. After amputation of the fingertip and terminal phalanx, the final diagnosis was subungual malignant melanoma. Further amputation of the entire finger and portion of the corresponding metacarpal bone was done as a successful follow-up procedure.