A rare presentation of a subungual melanoma with distant metastasis

Abstract

Subungual melanoma is a rare melanoma globally and melanoma by itself is reported rarely from the Indian population. This case is being reported for the rare occurrence of subungual melanoma in the Indian population and also for presentation with a long history of the lesion with no evidence of metastasis. Hereby presenting a rare case of a 40-year-old male who presented with blackish discoloration and ulcer of the left index fingernail of 5 months' duration post history of trauma to the index finger. Examination revealed black dystrophic left index fingernail. A detailed examination showed a mass under the dystrophic nail. Histopathology revealed characteristic features of melanoma. A detailed evaluation revealed features of regional metastasis. The entire finger was then amputated surgically by disarticulation at the metacarpophalangeal joint and regional nodes removed by ipsilateral axillary dissection.