A misdiagnosed nail bed melanoma.

Nail bed melanoma or subungual melanoma is frequently misdiagnosed compared to other melanoma in other anatomic sites. We report the case of a 48-year-old woman presenting with a dystrophic and pigmented lesion of her fourth finger nail. This initial presentation had been mistaken for onychomycosis, but biopsy of nail bed and nail matrix confirmed nail bed melanoma. This case is presented to help increase the awareness of atypical presentations of acral melanoma.