Abstract
A 73-year-old female noticed longitudinal melanonychia of right thumb four years ago. The periungual grayish dark pigmented macule developed gradually in recent two years. She visited our clinic in January 1997, and the diagnosis of ungual melanoma was made clinically. Amputation and DAV-Feron therapy (DTIC, ACNU, VCR, IFN-β) were perfomed. We observed the lesion with dermatoscope, and the interesting findings were obtained. The longitudial melanonychia showed no specific finding in dermatoscopy, but in the lesion of Hutchinson's sign, crista dominant heterogeneous pigmentation was observed. This finding is consistent with that of acral lentiginous melanoma in situ. Interestingly, in that lesion, thin spiral pigmented structure was also found. This structure reflected the casting-off melanin in the eccrine duct of corneum histologically. The other four cases of ungual melanoma were studied using dermatoscope. We also mentioned these findigs, and the usefulness of dermatoscopy for the diagnosis of ungual melanoma was discussed.
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