Subungual malignant melanoma: a disease entity separate from other forms of cutaneous melanoma.

Abstract

SUMMARYThe characteristics and results of treatment of 30 patients with subungual malignant melanoma treated at the Sydney Melanoma Unit were studied. It was found that in several major respects subungual melanoma differed from other forms of cutaneous melanoma. Patients with subungual melanoma were considerably older than those with either superficial spreading or nodular melanoma and there was a preponderance of men with subungual melanoma of the upper extremity. Independent prognostic factors (such as tumour thickness) which are important in determining survival in patients with superficial spreading or nodular melanoma, had little consequence in patients with subungual melanoma. Despite the fact that the vast majority of subungual melanomas were very thick and ulcerated due to the delay in correctly diagnosing the disease clinically, overall survival rate was reasonably good, providing patients had an amputation of the entire digit together with either a prophylactic or therapeutic lymph node dissection. These findings indicate that subungual melanoma is a disease entity separate from other forms of cutaneous melanoma and that radical surgery is essential in all subungual melanoma patients.