The Diagnosis of Subungual Malignant Melanoma in the Early Stage

GOTO Mayuko, MATSUDA Haruna, ITO Yukako, KAI Yoshitaka, GOTO Mizuki, HATANO Yutaka, KATAGIRI Kazumoto, FUJIWARA Sakuhei, KATO Aiko, SHIMIZU Fumiaki, YOKOYAMA Shigeo

doi:10.2336/nishinihonhifu.72.101

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Other Title

爪甲下悪性黒色腫初期病変の診断
症例爪甲下悪性黒色腫初期病変の診断
ショウレイソウコウカアクセイコクショクシュショキビョウヘンノシンダン

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Description

A 66-year-old man presented with a dark brown-colored pigment line on his right fourth fingernail for five months. The width of the line was 3.8 mm. The color and shade of the line varied from light to dark, and Hutchinson sign was not observed. Because of irregular lines in dermoscopy, we suspected malignant melanoma, and excisional biopsy was performed. Biopsy specimens showed that atypical melanocytes had formed small nests. A diagnosis of malignant melanoma in situ was made. A 60-year-old woman visited us because of a blackish brown-colored line in her right first toenail for two years. The width of the line was 5 mm. The line had some lightly colored parts. Excisional biopsy specimens showed proliferation of atypical melanocytes, and a diagnosis of malignant melanoma in situ was made. Subungual malignant melanoma in the early stage is difficult to diagnose. We are often at a loss whether to perform surgery or not. We propose an algorithm to distinguish subungual malignant melanoma from longitudinal melanonychia.

Journal

The Nishinihon Journal of Dermatology

The Nishinihon Journal of Dermatology 72 (2), 101-105, 2010

Western Division of Japanese Dermatological Association

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