Can nail melanoma be diagnosed noninvasively? Traditional and more recently described methods (medical history and physical examination, the ABCDEF system to identify nail melanoma,1 dermoscopic examination of the nail plate2,3) all lack significant accuracy. This month's Archives features an article that compares an invasive procedure of intraoperative polarized light dermoscopy of the matrix and bed (requiring anesthesia, sterile preparation, partial or complete nail plate avulsion, and nail fold reflection prior to dermoscopy) with historical, clinical, and noninvasive methods for diagnosis of nail melanoma.4 The authors demonstrate that in a selected group of patients with pigmented nail bands, among all methods studied, intraoperative polarized light dermoscopy was the most accurate in diagnosing melanoma in situ.
Jellinek NJ. Dermoscopy Between the Lines. Arch Dermatol. 2010;146(4):431-433. doi:10.1001/archdermatol.2010.26