Subungual nail bed melanoma masquerading as tinea ungium

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" Subungual nail bed melanoma masquerading as tinea ungium "
Riahi, Ryan R; Cohen, Philip R; Goldberg, Leonard H

Document Type	:	AL
Record Number	:	924441
Doc. No	:	LA4z5191rj
Language of Document	:	English
Main Entry	:	Riahi, Ryan R; Cohen, Philip R; Goldberg, Leonard H
Title & Author	:	Subungual nail bed melanoma masquerading as tinea ungium [Article]\ Riahi, Ryan R; Cohen, Philip R; Goldberg, Leonard H
Title of Periodical	:	Dermatology Online Journal
Volume/ Issue Number	:	24/6
Date	:	2018
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.