Subungual nail bed melanoma masquerading as tinea ungium

Ryan R. Riahi, Philip R. Cohen, Leonard H. Goldberg

Research output: Contribution to journalLetter

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 languageEnglish (US)
Article number20
JournalDermatology Online Journal
Volume24
Issue number6
StatePublished - Jun 2018

Keywords

  • Amelanotic
  • Malignant
  • Masquerading
  • Melanoma
  • Mimicking
  • Nail
  • Onychomycosis
  • Subungual
  • Tumor
  • Unguium

ASJC Scopus subject areas

  • Dermatology

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