Subungual Melanoma – Management in the Modern Era

Publication date: Available online 16 August 2017
Source:Journal of Plastic, Reconstructive & Aesthetic Surgery
Author(s): D.J. Reilly, G. Aksakal, R.F. Gilmour, D.E. Gyorki, A. Chauhan, A. Webb, M.A. Henderson
Subungual melanoma is a rare subtype of cutaneous melanoma that arises from the structures of the nail apparatus. It presents most commonly in older patients and at an advanced stage.A retrospective review of all patients with subungual melanoma in a single institution over a 15-year period was performed. 54 patients were included (26 males, average age 62.9 years). 28 cases involved the upper limb. Median tumour thickness was 4.5mm. 18 patients had lymph node metastasis at diagnosis, including 11 of 36 patients with positive sentinel lymph node biopsy. Median survival was 4.6 years.Subungual melanoma has a poor prognosis, strongly associated with presence of nodal disease at diagnosis. Sentinel lymph node biopsy should be considered to determine stage and prognosis.



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