Summary
Acral lentiginous melanoma is rare, representing approximately 1% of malignant melanomas.
Overall 5 year survival is disproportionately poor (25–51%) compared to other histological
subtypes. This has been attributed to diagnostic delay resulting in more advanced
presentation. Subungual presentation in the fingers is uncommon, reported in 1–13%
of all acral lentiginous melanomas. We report a unique and diagnostically challenging
case. Contrary to previously reported examples in the literature, the actual neoplastic
pathology was detected in the less pigmented finger tip skin rather than the deeply
pigmented nail bed germinal and sterile matrix that showed no evidence of malignancy.
We therefore advocate that in cases where skin surrounding the nail is involved, this
surrounding skin should also be biopsied, even if it is less pigmented than the primary
lesion.
Keywords
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Article info
Publication history
Published online: March 26, 2012
Accepted:
March 1,
2012
Received:
January 21,
2012
Identification
Copyright
© 2012 Published by Elsevier Inc. All rights reserved.
