Abstract
Subungual amelanotic melanoma can masquerade as onychomycosis. Recently a man whose amelanotic nail bed melanoma presented as persistent onychodystrophy was reported in the Dermatology Online Journal. The patient had a persistent nail dystrophy; culture and biopsy of the nail demonstrated Candida and dermatophyte infection, respectively. However, he subsequently presented with a nodule that was biopsied and demonstrated melanoma. Similar to that patient, we recently described a 67-year-old woman with a four-year history of persistent nail dystrophy of the left fourth fingernail who had a periodic acid-Schiff staining of the nail plate demonstrating fungal hyphae. Her nail plate subsequently detached, demonstrating a friable nodule; a biopsy of the nodule demonstrated melanoma. In conclusion, in individuals with new morphologic changes to a dystrophic nail or with persistent nail dystrophy despite appropriate therapy, it is important for clinicians to consider performing additional evaluation and possible biopsy to exclude malignancy.
Original language | English (US) |
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Article number | 20 |
Journal | Dermatology Online Journal |
Volume | 24 |
Issue number | 6 |
State | Published - Jun 2018 |
Keywords
- Amelanotic
- Malignant
- Masquerading
- Melanoma
- Mimicking
- Nail
- Onychomycosis
- Subungual
- Tumor
- Unguium
ASJC Scopus subject areas
- Dermatology