J Korean Soc Surg Hand.  2017 Mar;22(1):68-72. 10.12790/jkssh.2017.22.1.68.

Atypical Presentation of Subungal Melanoma

• Hwang SH
• Bahk S
• Eo S

• KMID: 2375470
• DOI: http://doi.org/10.12790/jkssh.2017.22.1.68

Abstract

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.

Keyword

Fingers; Melanoma; Atypical forms

MeSH Terms

Aged, 80 and over
Biopsy
Diagnosis
Female
Fingers
Humans
Melanoma*
Pigmentation
Skin
Thumb