Subungual melanoma: a deceptive disorder.

Acta dermatovenerologica Croatica : ADC / Hrvatsko dermatolosko drustvo

PubMedID: 19111151

Patel GA, Ragi G, Krysicki J, Schwartz RA. Subungual melanoma: a deceptive disorder. Acta Dermatovenerol Croat. 2008;16(4):236-42.
Subungual melanoma is an uncommon form of acral melanoma that arises within the nail bed. The incidence for acral melanomas is similar worldwide, but the proportion is higher in dark-skinned individuals. The subungual form represents about 2% of cutaneous non-sun induced melanomas in the western world, and up to 75% in Africans, 10% in Japanese, and 25% in the Chinese of Hong Kong. Up to 33% of subungual melanomas are amelanotic. Black pigmentation of the adjacent nail fold, termed Hutchinson's sign, may be a diagnostic clue. Non-specific features and symptoms along with a high incidence of amelanosis often lead to delayed diagnosis, disease progression, and a poor prognosis with challenging treatment options.