Management of Nail Unit Melanoma - 19/03/21

Doi : 10.1016/j.det.2020.12.006

Junqian Zhang, MD ^a,^{^{1
co-first authors.}}, Sook Jung Yun, MD, PhD ^b,^{^{1
co-first authors.}}, Stacy L. McMurray, MD ^c, Christopher J. Miller, MD ^c,^⁎
^a Department of Dermatology, University of Pennsylvania Health System, 3600 Spruce Street, 2 Maloney Building, Philadelphia, PA 19104, USA
^b Department of Dermatology, Chonnam National University Medical School, 160 Baekseo-Ro, Dong-Gu, Gwangju 61469, Korea (South)
^c Penn Dermatology Oncology Center, University of Pennsylvania Health System, 3400 Civic Center Boulevard, Suite 1-330S, Philadelphia, PA 19104, USA

^∗Corresponding author.

Résumé

Nail unit melanoma is an uncommon form of melanoma with worse prognosis compared with nonacral cutaneous melanoma. Nail unit melanoma is often diagnosed at a late stage. Clinical and dermoscopic features may suggest a diagnosis of nail unit melanoma, but confirmation requires histologic analysis. Like the clinical diagnosis, histopathologic diagnosis of nail unit melanoma is also difficult. The surgical management of nail unit melanoma has evolved from aggressive amputations to digit-sparing approaches. This article reviews the clinical presentation, diagnosis, and surgical treatment of nail unit melanoma to promote early diagnosis and rational surgery.

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Keywords : Melanoma, Nail unit, Amputation, Functional surgery, Mohs micrographic surgery

Plan

Key points

Introduction

Clinical presentation

Biopsy to diagnose nail unit melanoma

Staging of nail unit melanoma

Management of nail unit melanoma

Digit Amputation

Digit-Sparing Approaches

Metastatic Disease

Summary

Clinics care points

	J. Zhang and S.J. Yun contributed equally to all aspects of this article and are co-first authors.
	Funding Sources: None.
	Conflict of Interest Disclosures: No authors involved in the production of this article have any commercial associations that might create or pose a conflict of interest with information presented herein. Such associations include consultancies, stock ownership, or other equity interests, patent licensing arrangements, and payments for conducting or publicizing a study described in the article.