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Early features of subungual melanoma

Discussion in 'Foot Surgery' started by NewsBot, Feb 2, 2008.

  1. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
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    Subungual melanoma: a study of 124 cases highlighting features of early lesions, potential pitfalls in diagnosis, and guidelines for histologic reporting.
    Tan KB, Moncrieff M, Thompson JF, McCarthy SW, Shaw HM, Quinn MJ, Li LX, Crotty KA, Stretch JR, Scolyer RA.
    Am J Surg Pathol. 2007 Dec;31(12):1902-12.
     
  2. Admin2

    Admin2 Administrator Staff Member

  3. adavies

    adavies Active Member

    Does anyone have a quick way to diagnose a subungual melanoma?
     
  4. drsarbes

    drsarbes Well-Known Member

    Hi Adavies:

    Just saw this post...from NOV 2007! Time flies!

    In any event, I fell it's better to err on the conservative side. If you see a pigmented lesion under or at the nail border that is fairly NEW or has changed (or if the patient has just noticed it but is unsure of the chronicity) I would biopsy.

    The first thing I do for SubUngual pigmentation is to make sure it is not just an old hematoma from a long forgotten toe stubbing. If you can currette it away (even partially) then obviously it is not pigmented. Leave it.

    For all others, I would biopsy. If I have a patient with numerous nevi or "moles" I approach it differently. If they are all fairly consistent in color, texture, size and border definition then I leave them. If one stands out, biopsy.

    I just had one three weeks ago. I had the patient scheduled for a 1st MTPJ implant and she had numerous pigmented lesions on both feet. One, however, on the lateral border of the 5th MTPJ was more bluish-darker than the rest, slightly raised and somewhat mottled in appearance with about 25% of the border "hazy". This type should be biopsied.

    I have had two come back melanoma. Both on the Hallux. One subungual, one just on the epinychium. One patient did not make it to five years.

    Hope that helps

    Steve
     
  5. adavies

    adavies Active Member

    Hi Steve,

    thanks for the reply.
    It's one of those things like a red bus, nothing for ages, then they all arrive at once!

    AD
     
  6. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
  7. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
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    Subungual melanoma is not so rare: Report of four cases from India.
    Singal A, Pandhi D, Gogoi P, Grover C.
    Indian Dermatol Online J 2017;8:471-4
     
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