Subungual melanoma is frequently misdiagnosed, probably because of its nonspecific clinical features and rarity. Hutchinson in 1886 first referred to what he termed melanotic whitlow, a coal-black discoloration at the edge of an inflamed nail. Subungual melanomas represent approximately 2% of all melanomas and most often occur in the fifth to seventh decades of life. The common sites reported are the nails of big toes and thumbs. They account for a greater proportion of melanomas in nonwhite persons. One study in a Japanese population found that more than 30% of melanomas involved the digits.
Approximately 15 to 25% of cases of subungual melanoma are amelanotic. The lack of pigmentation of the lesion may cause misdiagnosis and aggravate its poor prognosis. We herein report on a case of amelanotic subungual melanoma extended to the adjacent skin in a 36-year-old Korean woman.
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