Nail melanoma in situ: clinical, dermoscopic, pathologic clues, and steps for minimally invasive treatment

Duarte, Ana F; Correia, Osvaldo; Barros, Ana M; Ventura, Filipa; Haneke, Eckart (2015). Nail melanoma in situ: clinical, dermoscopic, pathologic clues, and steps for minimally invasive treatment. Dermatologic surgery, 41(1), pp. 59-68. Blackwell 10.1097/DSS.0000000000000243

[img]
Preview
Text
00042728-201501000-00008.pdf - Published Version
Available under License Publisher holds Copyright.

Download (895kB) | Preview

BACKGROUND Nail unit melanoma (NUM) is a variant of acral lentiginous melanoma. The differential diagnosis is wide but an acquired brown streak in the nail of a fair-skinned adult person must be considered a potential melanoma. Dermoscopy helps clinicians to more accurately decide if a nail apparatus biopsy is necessary. OBJECTIVE Detailed evaluation of clinical and dermoscopy features and description of conservative surgery of in situ NUM. METHODS Retrospective study of in situ NUM diagnosed and treated with conservative surgical management in the authors' center from 2008 to 2013. RESULTS Six cases of NUM were identified: 2 male and 4 female patients, age range at diagnosis of 44 to 76 years. All patients underwent complete nail unit removal with at least 6-mm security margins around the anatomic boundaries of the nail. The follow-up varies from 4 to 62 months. CONCLUSION Nail unit melanomas pose a difficult diagnostic and therapeutic challenge. Wide excision is sufficient, whereas phalanx amputation is unnecessary and associated with significant morbidity for patients with in situ or early invasive melanoma. Full-thickness skin grafting or second-intention healing after total nail unit excision is a simple procedure providing a good functional and cosmetic outcome.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Dermatology, Urology, Rheumatology, Nephrology, Osteoporosis (DURN) > Clinic of Dermatology

UniBE Contributor:

Haneke, Eckart

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1076-0512

Publisher:

Blackwell

Language:

English

Submitter:

Sandra Nyffenegger

Date Deposited:

14 Mar 2016 10:22

Last Modified:

16 Mar 2016 00:15

Publisher DOI:

10.1097/DSS.0000000000000243

PubMed ID:

25521106

BORIS DOI:

10.7892/boris.76603

URI:

https://boris.unibe.ch/id/eprint/76603

Actions (login required)

Edit item Edit item
Provide Feedback