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KMID : 0621520170220010068
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Journal of the Korean Society for Surgery of the Hand
2017 Volume.22 No. 1 p.68 ~ p.72
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Atypical Presentation of Subungal Melanoma
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Hwang Seung-Hwan
Bahk Su-Jin
Eo Su-Rak
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Abstract
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Malignant melanomas sometimes present with nail or periungual pigmentation, as a subungual melanoma. This pigmentation also occurs in nonmelanoma skin disorders. Therefore, biopsy is mandatory for the absolute diagnosis. We present an atypical presentation of subungual melanoma in an 81-year-old female patient with no specific periungual pigmentation. She suffered from a crushing injury in her right thumb 2 years ago and had undergone repetitive stump plasty at a local clinic. Recently, she felt intermittent pain at the thumb tip. During the revisional stump plasty, we unexpectedly noted a spread out of dark colored soft tissues the distal phalanx. Pathological examination revealed subungual malignant melanoma. This unusual form of melanoma has a predilection for an acral location, particularly the paronychial region. Even when small pigments are found on the periungual area, careful examination and identification of a component of melanoma is necessary in order to not miss any malignant finger lesion.
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KEYWORD
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Fingers, Melanoma, Atypical forms
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