In Situ Amelanotic Melanoma of the Nail Unit Mimicking Lichen Planus: Report of 3 Cases | Dermatology | JAMA Dermatology | JAMA Network
[Skip to Navigation]
Access to paid content on this site is currently suspended due to excessive activity being detected from your IP address 18.206.177.17. Please contact the publisher to request reinstatement.
Observation
April 2010

In Situ Amelanotic Melanoma of the Nail Unit Mimicking Lichen Planus: Report of 3 Cases

Author Affiliations

Authors Affiliations: Department of Dermatology, Centres Hospitaliers Universitaires Saint-Pierre & Brugmann and Hôpital Universitaire des Enfants Reine Fabiola–Université Libre de Bruxelles, Brussels, Belgium (Dr André); and Cabinet de Dermatopathologie (Dr Moulonguet) and Department of Dermatology, Hôpital Bichat (Dr Goettmann-Bonvallot), Paris, France.

Arch Dermatol. 2010;146(4):418-421. doi:10.1001/archdermatol.2010.43
Abstract

Background  Nail apparatus melanoma is known to be associated with a poor prognosis, mainly because of a delay in diagnosis that is made at an invasive stage. This delay is particularly true in cases involving amelanotic melanoma. To our knowledge, only 1 case of in situ amelanotic melanoma of the nail unit has previously been described. We report 3 cases of in situ amelanotic melanoma with clinical lichenoid features.

Observations  We describe 3 cases of in situ amelanotic melanoma of the nail unit. The patients ranged in age from 39 to 60 years. The lesions were located on the thumb (2 cases) or on the index finger (1 case). The duration of evolution was 6 to 18 months. Nail alterations were characterized by lichenoid changes with longitudinal striation, distal splitting, and nail plate atrophy. Histologic examination revealed in situ amelanotic melanoma extending from the proximal matrix up to the distal part of the nail bed. Complete excision of the nail apparatus was performed. There has been no sign of recurrence after follow-up of 1, 5, and 6 years.

Conclusions  Monodactylic lichenoid nail changes should be added to the more conventional signs of incipient nail melanoma. Chronic unexplained monodactylic nail dystrophy, especially in adults, should always be investigated histologically.

×